Provider Demographics
NPI:1902898760
Name:CRASNER, JOSHUA M (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:M
Last Name:CRASNER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:539 EGG HARBOR RD
Practice Address - Street 2:#1 WASHINGTON MEDICAL ARTS BUILDING
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2371
Practice Address - Country:US
Practice Address - Phone:856-589-0300
Practice Address - Fax:856-589-1753
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB05575800207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6606300Medicaid
F56469Medicare UPIN
NJ6606300Medicaid