Provider Demographics
NPI:1881178846
Name:CROSSTOWN CLINICS LLC
Entity type:Organization
Organization Name:CROSSTOWN CLINICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:E
Authorized Official - Last Name:COLABELLA
Authorized Official - Suffix:
Authorized Official - Credentials:DPM, MS
Authorized Official - Phone:800-849-8121
Mailing Address - Street 1:57 TAURUS DR UNIT 4A
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5071
Mailing Address - Country:US
Mailing Address - Phone:908-285-3217
Mailing Address - Fax:908-281-9209
Practice Address - Street 1:611 HIGHWAY 74 S STE 100
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3082
Practice Address - Country:US
Practice Address - Phone:800-849-8121
Practice Address - Fax:908-281-9209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty