Provider Demographics
NPI:1689998387
Name:CRUZ, BENJAMIN GENEROSO JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:GENEROSO
Last Name:CRUZ
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:NY PRESBYTERIAN HOSPITAL (PHARMACY)
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-342-8555
Mailing Address - Fax:212-342-8552
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:NY PRESBYTERIAN HOSPITAL (PHARMACY)
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-342-8555
Practice Address - Fax:212-342-8552
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY041694-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist