Provider Demographics
NPI:1841614419
Name:CRUZ, MARIA ANTONIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANTONIA
Last Name: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 1:281 W 127TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-2903
Mailing Address - Country:US
Mailing Address - Phone:212-865-1300
Mailing Address - Fax:212-865-9734
Practice Address - Street 1:281 W 127TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-2903
Practice Address - Country:US
Practice Address - Phone:212-865-1300
Practice Address - Fax:212-865-9734
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator