Individual
DR. WILFREDO TOMAS CORREA CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 SAINT PAULS AVE APT 1D, JERSEY CITY, NJ 07306-3708
(201) 656-7400
(201) 653-7960
Mailing address
328 RIDGE ST, NEWARK, NJ 07104-1311
(973) 866-9612
(201) 653-7960
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA07690500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0026212
—
NJ
Enumeration date
06/28/2006
Last updated
08/28/2018
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