Provider Demographics
NPI:1609833961
Name:CRUZ, DIONISIO V (MD)
Entity Type:Individual
Prefix:
First Name:DIONISIO
Middle Name:V
Last Name:CRUZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2100 STATE ROUTE 33
Mailing Address - Street 2:STE 15
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-6116
Mailing Address - Country:US
Mailing Address - Phone:732-451-0063
Mailing Address - Fax:732-451-0059
Practice Address - Street 1:35 BEAVERSON BLVD
Practice Address - Street 2:STE 5C
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7858
Practice Address - Country:US
Practice Address - Phone:732-451-0063
Practice Address - Fax:732-451-0063
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2019-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03414900207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0042599OtherAETNA
NJ1709607Medicaid
NJ222271316OtherBCBS
NJ0042599OtherAETNA
NJ535701B7DMedicare ID - Type Unspecified