Provider Demographics
NPI:1518221969
Name:CRUZ, CLARIBEL (TSHH)
Entity Type:Individual
Prefix:
First Name:CLARIBEL
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502-1048
Mailing Address - Country:US
Mailing Address - Phone:845-638-3072
Mailing Address - Fax:
Practice Address - Street 1:23 WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-7025
Practice Address - Country:US
Practice Address - Phone:845-290-0013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-30
Last Update Date:2012-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7269561744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study