Provider Demographics
NPI:1184160236
Name:KRUZ, ALLA
Entity type:Individual
Prefix:MRS
First Name:ALLA
Middle Name:
Last Name:KRUZ
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 1:2925 W 5TH ST APT 23B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3981
Mailing Address - Country:US
Mailing Address - Phone:646-221-8433
Mailing Address - Fax:
Practice Address - Street 1:2925 W 5TH ST APT 23B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3981
Practice Address - Country:US
Practice Address - Phone:646-221-8433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0850592471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography