| Crescent Medical Center LLC | |
|
1308 Atwood Ave Johnston RI 02919-4936 | |
| (401) 227-9940 | |
| (401) 227-9939 |
| Full Name | Crescent Medical Center LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 1308 Atwood Ave, Johnston, Rhode Island |
| Authorized Official Name and Position | Syed I Hussain (PRESIDENT) |
| Authorized Official Contact | 4015246020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Medical Center LLC 1308 Atwood Ave Johnston RI 02919-4936 Ph: (401) 227-9940 | Crescent Medical Center LLC 1308 Atwood Ave Johnston RI 02919-4936 Ph: (401) 227-9940 |
| NPI Number | 1932076973 |
|---|---|
| Provider Enumeration Date | 10/23/2025 |
| Last Update Date | 11/20/2025 |
| Certification Date | 11/20/2025 |
| Medicare PECOS PAC ID | 3072008192 |
|---|---|
| Medicare Enrollment ID | O20251216004043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932076973 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Syed Iftikhar Hussain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144285081 PECOS PAC ID: 3678512779 Enrollment ID: I20050428000160 |
| Provider Name | Raza Naqvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235651332 PECOS PAC ID: 0244651974 Enrollment ID: I20200604000128 |
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