| Doctor Name: | SUSANNA CRONMILLER |
| NPI Number: | 1003141706 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | F.N.P. |
| License Number: | 335939 |
| Business Practice Address: | 140 Lockwood Ave Suite 216 New Rochelle, NY - 108014915 |
| Business Phone Number: | 9142356900 |
| Business Fax Number: | 9142357900 |
| Mailing Address: | 441 9th Ave, Credentialing 3rd Fl NEW YORK |
| State: | NY |
| Postal Code: | 100011623 |
| Phone Number: | 6466802894 |
| Fax Number: | 5165425556 |
| NPI Enumeration Date: | 10/14/2009 |
| NPI Last Update Date: | 12/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 335939 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |