Provider Demographics
NPI:1083945331
Name:CRUZ, JOCELYN S (MSW)
Entity Type:Individual
Prefix:MRS
First Name:JOCELYN
Middle Name:S
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5140 59TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7413
Mailing Address - Country:US
Mailing Address - Phone:718-639-2931
Mailing Address - Fax:718-334-0399
Practice Address - Street 1:5140 59TH ST
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-7413
Practice Address - Country:US
Practice Address - Phone:718-639-2931
Practice Address - Fax:718-334-0399
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP73944104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker