Provider Demographics
NPI:1750874277
Name:MC TIGHE, KRYSTAL MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:MARIE
Last Name:MC TIGHE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:205 E LAKE DR
Mailing Address - Street 2:
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534-6387
Mailing Address - Country:US
Mailing Address - Phone:973-897-7264
Mailing Address - Fax:
Practice Address - Street 1:495 JACK MARTIN BLVD STE 5
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7778
Practice Address - Country:US
Practice Address - Phone:732-458-8000
Practice Address - Fax:732-458-8020
Is Sole Proprietor?:No
Enumeration Date:2018-06-09
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019046477207Q00000X
NJ25MA12590900207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine