Organization
IMELDA CRUZ-BANTING, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IMELDA MANGAHAS CRUZ-BANTING (OWNER)
(914) 779-3710
Entity
Organization
Contact information
Practice address
108 VAN GUILDER AVE, NEW ROCHELLE, NY 10801-5406
(914) 712-3144
(718) 944-6266
Mailing address
12 APPLE CT, EASTCHESTER, NY 10709-5540
(914) 779-3710
(718) 944-6266
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
212537
NY
261QM2500X
Medical Specialty Clinic/Center
212537
NY
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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