Provider Demographics
NPI:1235298027
Name:CRUZ, STELLA MARIE CRUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:STELLA MARIE
Middle Name:CRUZ
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 CASSANDRA DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6926
Mailing Address - Country:US
Mailing Address - Phone:724-742-4724
Mailing Address - Fax:
Practice Address - Street 1:114 LT MICHAEL CLEARY DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:PA
Practice Address - Zip Code:18612-1649
Practice Address - Country:US
Practice Address - Phone:570-675-2000
Practice Address - Fax:570-675-1806
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429903208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics