Organization
CRESCENT INTERNAL MEDICINE GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD TODD KRUPP D.O. (OWNER/PHYSICIAN)
(973) 783-0800
Entity
Organization
Contact information
Practice address
29 THE CRESCENT, MONTCLAIR, NJ 07042-2636
(973) 783-0800
(973) 744-1274
Mailing address
29 THE CRESCENT, MONTCLAIR, NJ 07042-2636
(973) 783-0800
(973) 744-1274
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB071292
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00059104
RAILROAD MEDICARE
NJ
Enumeration date
09/25/2006
Last updated
04/20/2008
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