Provider Demographics
NPI:1225237019
Name:VINCE CRUZ, LIEZEL TORINO (NP)
Entity Type:Individual
Prefix:MS
First Name:LIEZEL
Middle Name:TORINO
Last Name:VINCE CRUZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2342 LODOVICK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6330
Mailing Address - Country:US
Mailing Address - Phone:917-853-5042
Mailing Address - Fax:
Practice Address - Street 1:2000 E GUNHILL RD
Practice Address - Street 2:KINGS HARBOR MULTICARE CENTER
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469
Practice Address - Country:US
Practice Address - Phone:718-944-3134
Practice Address - Fax:718-944-3177
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3045351363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health