Individual
IDALIA CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
28 DEBEVOISE ST STE 5, BROOKLYN, NY 11206-4194
(718) 963-4430
(646) 398-2794
Mailing address
145 W 15TH ST, 2ND FLOOR, NEW YORK, NY 10011-6701
(212) 924-6324
(212) 691-5635
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
172165
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040426033250
FIDELIS PROVIDER NUMBER
NY
Enumeration date
08/23/2006
Last updated
03/19/2019
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