Crystal Tank, MD
Internal Medicine in Glen Ridge, New Jersey
1043639453- Practice location
- 311 Bay Ave, Mmg Internal Med, Glen Ridge, NJ 07028
- Phone
- 973-748-9246
- Fax
- 973-748-8755
- Last updated
- February 17, 2020
Crystal Tank is an Internal Medicine based in Glen Ridge, NJ. Crystal Tank practices in Glen Ridge, NJ and has the professional credentials of MD. The NPI Number for Crystal Tank is 1043639453 and holds a License No. 25MA10421000 (NJ). The current practice location address for Crystal Tank is 311 Bay Ave, Mmg Internal Med, Glen Ridge, NJ 07028 and can be reached out via phone at 973-748-9246 and via fax at 973-748-8755.
Provider Profile Details
- NPI Number
- 1043639453
- Provider Name
- Crystal Tank
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 311 Bay Ave, Mmg Internal Med, Glen Ridge, NJ 07028
- Phone Number
- 973-748-9246
- Fax Number
- 973-748-8755
- Primary Taxonomy
- Internal Medicine · 207R00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 14, 2014
- Last Update Date
- February 17, 2020
- Certification Date
- February 17, 2020
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 311 Bay Ave
Mmg Internal Med
Glen Ridge, NJ 07028 - City
- Glen Ridge
- State
- New Jersey
- Zip
- 07028
- Phone Number
- 973-748-9246
- Fax Number
- 973-748-8755
Provider Business Mailing Address Details
- Address
- Po Box 419430
Boston, MA 02241-9430 - City
- Boston
- State
- MA
- Zip
- 02241-9430
- Phone Number
- 201-967-8221
- Fax Number
- 201-483-2242
License Information
- License Number
- 25MA10421000
- License State
- NJ
- Taxonomy
- Internal Medicine · 207R00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Crystal Tank, MD?
The NPI number of Crystal Tank, MD is 1043639453. It was assigned on April 14, 2014 and is currently active in the NPPES registry.
What is the specialty of Crystal Tank, MD?
Crystal Tank, MD is registered under the primary taxonomy Internal Medicine (code 207R00000X), licensed in NJ under license number 25MA10421000.
Where does Crystal Tank, MD practice?
The practice location is 311 Bay Ave, Mmg Internal Med, Glen Ridge, NJ 07028. The office can be reached at 973-748-9246 (phone) or 973-748-8755 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1043639453 directly on the NPPES registry website.