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1043639453
CRYSTAL TANK
GLEN RIDGE, NJ
NPI
1043639453
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NJ 25MA10421000)
Enumeration Date
2014-04-14
Last Update Date
2020-02-17
Business Address
CRYSTAL TANK M.D.
311 BAY AVE MMG INTERNAL MED
GLEN RIDGE, NJ 07028
Phone number: 973-748-9246
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Mailing Address
CRYSTAL TANK M.D.
PO BOX 419430
BOSTON, MA 02241-9430
Phone number: 201-967-8221
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