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Organization
KRYSTITE CARE LLC
Active
Organization
KRYSTITE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER TIKUM (OWNER/APN)
(848) 801-9248
Entity
Organization
Contact information
Practice address
640 EAGLE ROCK AVE STE 6, WEST ORANGE, NJ 07052-2931
(848) 801-9248
Mailing address
28 JOHNSON RD, WEST ORANGE, NJ 07052-3556
(848) 801-9248
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
08/08/2024
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