Organization
CRESCENT MEDICAL CARE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VYACHESLAV GALIBOV MD (OWNER)
(718) 997-6400
Entity
Organization
Contact information
Practice address
6425 ELLWELL CRSCENT, REGO PARK, NY 11374
(718) 997-6400
(718) 997-6405
Mailing address
6425 ELLWELL CRSCENT, REGO PARK, NY 11374
(718) 997-6400
(718) 997-6405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
221766
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02196050
—
NY
Enumeration date
07/20/2009
Last updated
07/20/2009
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