Individual
NICOLETTE ROSE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 689-8333
Mailing address
27 NORWOOD LN, RONKONKOMA, NY 11779-3317
(631) 559-7476
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
756705
NY
Other
Enumeration date
07/17/2025
Last updated
07/17/2025
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