Provider Demographics
NPI:1649619644
Name:CROWN FAMILY MEDICAL CARE
Entity type:Organization
Organization Name:CROWN FAMILY MEDICAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ADEDAYO
Authorized Official - Middle Name:
Authorized Official - Last Name:ADERIBIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:862-215-1678
Mailing Address - Street 1:21 KESWICK CIR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4906
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:629 AMBOY AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3579
Practice Address - Country:US
Practice Address - Phone:732-486-3365
Practice Address - Fax:732-486-3367
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-24
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA08693900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty