NPIMap

Organization Active NPI

Crystal Run Healthcare Physicians LLP

  • Clinical Medical Laboratory
  • Monroe, NY
National Provider Identifier
1609388289
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CRYSTAL RUN HEALTHCARE PHYSICIANS LLP
Practice address
807 State Route 17M
Monroe, NY 10950-2625
Phone
(845) 703-6999
Fax
(845) 703-6297
NPI assigned
Nov 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Hal David Teitelbaum, MD, JD, MBA
Title
Managing Partner & Ceo
Phone
(845) 703-6999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NY Primary

Addresses

Primary practice location

807 State Route 17M
Monroe, NY 10950-2625

Mailing address

155 Crystal Run Rd
Middletown, NY 10941-4028
Phone (845) 703-6999

National Provider Directory

National Provider Directory
Tax ID family
Michael Greenblatt MD5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515024000000",
    "number": "1609388289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109414028",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 STATE ROUTE 17M",
            "city": "MONROE",
            "state": "NY",
            "postal_code": "109502625",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RUN HEALTHCARE PHYSICIANS LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2018-01-04",
        "status": "A",
        "authorized_official_last_name": "TEITELBAUM",
        "authorized_official_first_name": "HAL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING PARTNER & CEO",
        "authorized_official_telephone_number": "845-703-6999",
        "authorized_official_credential": "MD, JD, MBA"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.