Individual
SOFIA A. DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
560 W 175TH ST, NEW YORK, NY 10033-8031
(212) 927-8873
(212) 927-8914
Mailing address
560 W 175TH ST, NEW YORK, NY 10033-8031
(212) 927-8873
(212) 927-8914
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
154771
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00860944
—
NY
Enumeration date
12/05/2006
Last updated
07/08/2007
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