Provider Demographics
NPI:1346869591
Name:SEVERINO DE LA CRUZ, ORIANA A
Entity Type:Individual
Prefix:
First Name:ORIANA
Middle Name:A
Last Name:SEVERINO DE LA CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10127 PRINCE PL APT 302
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1126
Mailing Address - Country:US
Mailing Address - Phone:443-616-8928
Mailing Address - Fax:
Practice Address - Street 1:10127 PRINCE PL APT 302
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-1126
Practice Address - Country:US
Practice Address - Phone:443-616-8928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-08
Last Update Date:2020-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant