Organization
CRYSTAL HEALTH CARE NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMOTUNDE D ADERIN NURSE PRACTITIONER (CEO)
(917) 653-0577
Entity
Organization
Contact information
Practice address
11410 MERRICK BLVD, JAMAICA, NY 11434-1335
(917) 653-0577
(516) 743-0323
Mailing address
1 WINTER LN, AMITYVILLE, NY 11701-1626
(917) 653-0577
(516) 743-0323
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/07/2025
Last updated
11/21/2025
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