Provider Demographics
NPI:1457436362
Name:CROMER, BRIAN PETER (NP)
Entity type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:PETER
Last Name:CROMER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CUSHING RD
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1720
Mailing Address - Country:US
Mailing Address - Phone:978-534-0582
Mailing Address - Fax:
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:SUITE 2D
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2253
Practice Address - Country:US
Practice Address - Phone:978-534-0582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR150873363LF0000X
NH0576632303363LF0000X
MA281715363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP99657Medicare UPIN