Individual
ALICE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
340 E 4TH ST, 5A, NEW YORK, NY 10009-8528
(646) 509-1205
Mailing address
340 E 4TH ST, 5A, NEW YORK, NY 10009-8528
(646) 509-1205
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
731249
NY
Other
Enumeration date
09/03/2015
Last updated
09/03/2015
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