Provider Demographics
NPI:1740265792
Name:CRUZEN, ERIC SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:SCOTT
Last Name:CRUZEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:30 7TH AVE
Mailing Address - Street 2:DEPT OF EMERGENCY MEDICINE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-6608
Mailing Address - Country:US
Mailing Address - Phone:646-665-6900
Mailing Address - Fax:646-665-6996
Practice Address - Street 1:30 7TH AVE
Practice Address - Street 2:DEPT OF EMERGENCY MEDICINE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-6608
Practice Address - Country:US
Practice Address - Phone:646-665-6900
Practice Address - Fax:646-665-6996
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY228260207P00000X
FLME82158207P00000X
CAA81145207P00000X
HIMD-12159207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H70660Medicare UPIN