Individual
JIMMY CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
961 REV JAMES A POLITE AVE APT 512, BRONX, NY 10459-3569
(347) 238-4273
Mailing address
961 REV JAMES A POLITE AVE APT 512, BRONX, NY 10459-3569
(347) 238-4273
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
1554292212
NY
252Y00000X
Early Intervention Provider Agency
1554292212
NY
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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