Provider Demographics
NPI:1255823746
Name:CRUZ, NATALIE ANN
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN
Last Name:CRUZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 BARBARA DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1924
Mailing Address - Country:US
Mailing Address - Phone:718-541-9321
Mailing Address - Fax:
Practice Address - Street 1:90 CRYSTAL RUN RD STE 203
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-7101
Practice Address - Country:US
Practice Address - Phone:845-513-3702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033218-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty