Individual
MARIO CRUZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7170
(215) 456-4923
Mailing address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7170
(215) 456-4923
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD432064
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1020627490005
—
PA
Enumeration date
04/18/2007
Last updated
08/16/2024
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