Organization
ANTONIO A. DE LA CRUZ, MD., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO A. DE LA CRUZ M.D. (PRESIDENT)
(732) 397-0772
Entity
Organization
Contact information
Practice address
559 BROAD ST, NEWARK, NJ 07102-4503
(973) 622-3890
Mailing address
25 PORSCHE DR, MATAWAN, NJ 07747-3538
(732) 397-0772
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
25MA03502300
NJ
207QA0401X
Addiction Medicine (Family Medicine) Physician
25MA03502300
NJ
208000000X
Pediatrics Physician
Primary
25MA03502300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2066807
—
NJ
Enumeration date
08/11/2006
Last updated
09/11/2025
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