Provider Demographics
NPI:1689986812
Name:CRUZ, CHERYLL DANE CRUZ (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CHERYLL DANE
Middle Name:CRUZ
Last Name:CRUZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3310 QUEENS BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-2302
Mailing Address - Country:US
Mailing Address - Phone:718-593-4121
Mailing Address - Fax:718-268-2646
Practice Address - Street 1:3310 QUEENS BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-2302
Practice Address - Country:US
Practice Address - Phone:718-593-4121
Practice Address - Fax:718-268-2646
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014766-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics