Provider Demographics
NPI:1003107590
Name:DELA CRUZ, MARITESS A (RN)
Entity Type:Individual
Prefix:MS
First Name:MARITESS
Middle Name:A
Last Name:DELA CRUZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIA TERESITA
Other - Middle Name:ALIBUGA
Other - Last Name:ABUTANMO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:271 FORT WASHINGTON AVE
Mailing Address - Street 2:APT 4F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1218
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:271 FORT WASHINGTON AVE
Practice Address - Street 2:APT 4F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1218
Practice Address - Country:US
Practice Address - Phone:347-380-3717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY439409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse