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Individual

MS. CLEOFE SECULAR CRUZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
1663 E 17TH ST, BROOKLYN, NY 11229-1259
(718) 998-0200
Mailing address
9705 HORACE HARDING EXPY, 14-O, CORONA, NY 11368-4157
(347) 420-9452

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
635507
NY
251300000X
Local Education Agency (LEA)
Primary
635507
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
740802257
FIDELIS CARE
NY
Enumeration date
01/16/2012
Last updated
01/16/2012
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