Provider Demographics
NPI:1619501731
Name:DELA CRUZ, JO-ANN TORRES
Entity Type:Individual
Prefix:MS
First Name:JO-ANN
Middle Name:TORRES
Last Name:DELA 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 1:2583 49TH ST FL 3
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-1120
Mailing Address - Country:US
Mailing Address - Phone:917-847-3234
Mailing Address - Fax:
Practice Address - Street 1:3 E 44TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-3600
Practice Address - Country:US
Practice Address - Phone:800-668-5972
Practice Address - Fax:917-832-6114
Is Sole Proprietor?:No
Enumeration Date:2020-02-27
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0058026225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant