Basic Information
| Provider Information | |||||||||
| NPI: | 1740294255 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KROUNER | ||||||||
| FirstName: | ANDREW | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7000 STONEWOOD DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150907376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249404001 | ||||||||
| FaxNumber: | 7249404036 | ||||||||
| Practice Location | |||||||||
| Address1: | 7000 STONEWOOD DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150907376 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249404001 | ||||||||
| FaxNumber: | 7249404036 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 09/25/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | MDO44167L | PA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 26587 | 01 | RI | RI BLUE SHIELD | OTHER | 050493136 | 01 | RI | UNITED | OTHER | 7058838 | 05 | RI | MEDICAID | 4207708 | 01 | RI | AETNA | OTHER | 32247 | 01 | RI | NEIGHBORHOOD RI | OTHER | 6591068 | 01 | RI | CIGNA | OTHER | 413873 | 01 | SC | BLUE CHIP | OTHER | AA73915 | 01 | RI | HARVARD | OTHER |