Individual
CRYSTAL DE LA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SAC
Contact information
Practice address
612 E 168TH ST APT 3A, BRONX, NY 10456-3865
(646) 242-9524
Mailing address
612 E 168TH ST APT 3A, BRONX, NY 10456-3865
(646) 242-9524
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
21-457
NY
Other
Enumeration date
08/05/2021
Last updated
08/05/2021
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