Individual
NORMAN CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
STONY BROOK UMC, HSC 18-040, STONY BROOK, NY 11794-8191
(631) 444-7989
(631) 444-6176
Mailing address
STONY BROOK UMC, HSC 18-040, STONY BROOK, NY 11794-8191
(631) 444-7989
(631) 444-6176
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
520603
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02940114
—
NY
01
—
2004004483-22
ANCC BOARD CERTIFICATION NUMBER
NY
01
—
520603-1
RN LICENSE
NY
01
—
F334419
FNP LICENSE
NY
Enumeration date
05/17/2006
Last updated
10/20/2014
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