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Individual
MARILYN CAVITE CRUZ-ROSAL
Active
Individual
MARILYN CAVITE CRUZ-ROSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT,DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
030347
NY
225100000X
Physical Therapist
Primary
070019010
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070019010
PHYSICAL THERAPY LICENSE
IL
01
—
586678724
STATE IDENTIFICATION CARD
NY
01
—
C620-5438-0877
IL DRIVER'S LICENSE
IL
Enumeration date
06/22/2010
Last updated
09/06/2013
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