# CRESCENT MEDICAL GROUP PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669027140
- **Authorized official:** MR. HR MANAGER (OWNER)
- **Authorized official phone:** (973) 777-0000

## Contact information

- **Practice address:** 141 CHESTNUT ST STE 202, ROSELLE PARK, NJ 07204-2282
- **Practice address phone:** (908) 280-9600
- **Practice address fax:** (908) 248-9390
- **Mailing address:** 141 CHESTNUT ST STE 202, ROSELLE PARK, NJ 07204-2282
- **Mailing address phone:** (908) 280-9600
- **Mailing address fax:** (908) 248-9390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/02/2019
- **Last updated:** 07/29/2025