# 25-15 CRESCENT STREET MEDICAL PC

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

## Provider details

- **NPI number:** 1770243529
- **Authorized official:** JAMES GOHAR MD (OWNER)
- **Authorized official phone:** (718) 897-5331

## Contact information

- **Practice address:** 10818 63RD RD, FOREST HILLS, NY 11375-1352
- **Practice address phone:** (718) 897-5331
- **Mailing address:** 10818 63RD RD, FOREST HILLS, NY 11375-1352
- **Mailing address phone:** (718) 897-5331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/21/2021
- **Last updated:** 12/21/2021