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General NPI Number Information
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NPI Number | 1821057837
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Entity Type | Organization
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Legal Business Name | CRESCENT MULISPECIALITY GROUP LLC
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/01/2009
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Provider Practice Location Address
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Address Line | 20 WHITE RD SUITE B
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4039
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Country | US
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Telephone | 732-747-4723
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Fax | 732-747-5998
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Provider Business Mailing Address
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Address Line | 20 WHITE RD STE B
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City | SHREWSBURY
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State | NJ
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Zip | 07702-4039
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Country | US
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Telephone | 732-747-4723
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Fax | 732-747-5998
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAHID WASEEM FAROOQUI
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Credential | M.D.
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Telephone | 732-747-4723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MA50568
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License Number State | NJ
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