CRYSTAL TANK (NPI# 1043639453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043639453 |
| Entity Type | Individual |
| Full Name | CRYSTAL TANK |
| Credential | M.D. |
| Practice Address |
311 Bay Ave Mmg Internal Med Glen Ridge NJ 07028 |
| Mailing Address |
Po Box 419430 Boston MA 02241-9430 |
| Practice Telephone | 9737489246 |
| Practice Fax Number | 9737488755 |
| Mailing Telephone | 2019678221 |
| Mailing Fax Number | 2014832242 |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2020-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 25MA10421000 | NJ | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982148672 | Crystal Tank | Acupuncturist | 21311 41st Ct W, Mountlake Terrace, WA 98043-6523 | 2016-12-14 |
| Street Address |
311 BAY AVE MMG INTERNAL MED |
| City | GLEN RIDGE |
| State | NJ |
| Zip Code | 07028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689668683 | Efthymios I Daniskas | Internal Medicine | 311 Bay Ave, Mmg Pulmonology, Glen Ridge, NJ 07028 | 2005-09-06 |
| 1982990479 | Rosemarie Arena | Internal Medicine | 311 Bay Ave, Glen Ridge, NJ 07028-1607 | 2011-06-22 |
| 1881891109 | Anjali Grover | Internal Medicine | 311 Bay Ave, Mmg Endocrinology, Glen Ridge, NJ 07028 | 2007-06-29 |
| 1841387925 | Juhayna Kassem Davis | Internal Medicine | 311 Bay Ave, Mmg Pulmonology, Glen Ridge, NJ 07028 | 2006-10-09 |
| 1578513131 | Sangbaek Charles Oh | Internal Medicine | 311 Bay Ave, Mmg Gastroenterology, Glen Ridge, NJ 07028 | 2006-05-12 |
| 1487648218 | Barry J Weber | Internal Medicine | 311 Bay Ave, Mmg Pulmonology, Glen Ridge, NJ 07028 | 2005-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346862463 | Kamlesh Mehrotra | Counselor | 192 Midland Ave, Glen Ridge, NJ 07028 | 2020-05-12 |
| 1821648965 | Sally Pitanga | Social Worker | 46 Victor Avenue, Glen Ridge, NJ 07028 | 2019-09-19 |
| 1487782579 | Kamlesh Khanna | Pediatrics | 401 Ridgewood Ave, Glen Ridge, NJ 07028 | 2007-03-01 |
| 1326111238 | Geraldine S Meanor | Internal Medicine | 150 Ridgewood Avenue, Glen Ridge, NJ 07028 | 2006-11-16 |
| 1134210305 | Cheryl D Ackerman | Dermatology | 368 Ridgewood Ave, Glen Ridge, NJ 07028 | 2006-09-27 |
| 1679530588 | Reuben Rozanski | Dermatology | 200 Highland Avenue, Glen Ridge, NJ 07028 | 2006-04-26 |
| 1629046388 | Ellen E Urrutia | Internal Medicine | 946 Bloomfield Avenue, Glen Ridge, NJ 07028 | 2006-03-09 |
| 1487632436 | Gastroenterology Group of New Jersey Pa | Internal Medicine | 123 Highland Avenue, Suite 103, Glen Ridge, NJ 07028 | 2006-01-09 |
| 1255833281 | Lavinia May Couture | Physician Assistant | 230 Sherman Ave, Glen Ridge, NJ 07028 | 2018-03-06 |
| 1104205111 | B3yond Nutrition, LLC | Dietitian, Registered | 2 Ardsley Rd, Glen Ridge, NJ 07028 | 2015-05-22 |
| Find all providers in zip 07028 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326111238 | Geraldine S Meanor | Internal Medicine | 150 Ridgewood Avenue, Glen Ridge, NJ 07028 | 2006-11-16 |
| 1083081392 | Paul Woroch | Internal Medicine | 123 Highland Ave, Suite 201, Glen Ridge, NJ 07028-1527 | 2015-08-24 |
| 1780985267 | Raghav Rastogi | Internal Medicine | 123 Highland Ave, Glen Ridge, NJ 07028-1527 | 2010-11-15 |
| 1548575137 | Christopher Di Giorgio | Internal Medicine | 946 Bloomfield Ave, Glen Ridge, NJ 07028-1308 | 2010-08-09 |
| 1548590698 | Khanna Nephrology, L.L.C. | Internal Medicine | 401 Ridgewood Ave, Glen Ridge, NJ 07028-1512 | 2010-01-12 |
| 1164698445 | Khaula Khalid | Internal Medicine | 946 Bloomfield Ave, Glen Ridge, NJ 07028-1308 | 2008-05-06 |
| 1184820557 | Ankitkumar Kirankumar Patel | Internal Medicine | 123 Highland Ave, Suite 302, Glen Ridge, NJ 07028-1527 | 2007-06-22 |
| 1538364351 | Medical Associates of Montclair | Internal Medicine | 123 Highland Ave, Suite 201, Glen Ridge, NJ 07028-1522 | 2007-06-20 |
| 1295940161 | Priya Khanna | Internal Medicine | 401 Ridgewood Ave, Glen Ridge, NJ 07028-1512 | 2007-05-13 |
| 1528186384 | Yong Min Kwon | Internal Medicine | 123 Highland Ave, Glen Ridge, NJ 07028-1527 | 2007-03-27 |
| Find all providers in GLEN RIDGE | ||||
| City | GLEN RIDGE |
| Zip Code | 07028 |
Please comment or provide details below to improve the information on CRYSTAL TANK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.