Provider Demographics
NPI:1275560377
Name:CRUZ ARRIETA, EDUVIGIS (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDUVIGIS
Middle Name:
Last Name:CRUZ ARRIETA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CENTRAL PARK W
Mailing Address - Street 2:SUITE 1I
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7253
Mailing Address - Country:US
Mailing Address - Phone:646-490-0654
Mailing Address - Fax:
Practice Address - Street 1:25 CENTRAL PARK W
Practice Address - Street 2:SUITE 1I
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7253
Practice Address - Country:US
Practice Address - Phone:646-490-0654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013922103G00000X, 103TC0700X, 103TC2200X, 103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY270982OtherMHN PRACTIONER ID #
NYVH0171Medicare ID - Type Unspecified