Individual
ERNESTO SANTIAGO CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3646
(215) 707-3644
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 707-3646
(215) 707-3644
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD053680L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01646061
—
PA
Enumeration date
01/26/2006
Last updated
03/27/2013
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