Provider Demographics
NPI:1093945123
Name:MATEO, EUGENIO CRUZ (MD,MPH&TM)
Entity Type:Individual
Prefix:DR
First Name:EUGENIO
Middle Name:CRUZ
Last Name:MATEO
Suffix:
Gender:M
Credentials:MD,MPH&TM
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:125 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4497
Mailing Address - Country:US
Mailing Address - Phone:212-225-1482
Mailing Address - Fax:212-225-1489
Practice Address - Street 1:125 WHITE ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4497
Practice Address - Country:US
Practice Address - Phone:212-225-1482
Practice Address - Fax:212-225-1489
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1614712083P0901X
NJ25MA045627002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine