Individual
DR. ALAN LARDIZABAL CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
45 SECOND ST, TROY, NY 12180
(518) 272-7191
(518) 272-7234
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
(518) 649-4094
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
236632
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000415387001
BLUE CROSS BLUE SHIELD
NY
05
—
02740958
—
NY
01
—
10100306
CDPHP
NY
Enumeration date
10/14/2006
Last updated
05/10/2021
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