Individual
MR. JAN ERICSON CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
150 GRANITE AVE, STATEN ISLAND, NY 10303-2718
(718) 816-1422
Mailing address
150 GRANITE AVE, STATEN ISLAND, NY 10303-2718
(718) 816-1422
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-12-10214
NY
Other
Enumeration date
05/19/2014
Last updated
05/29/2014
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