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NPI Code Detail

MEDICARE: MARY DE LA CRUZ PEREZ

MEDICARE:   MARY  DE LA CRUZ PEREZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1225989890
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY DE LA CRUZ PEREZ
Provider Business Mailing Address
First Line : 310 SAINT NICHOLAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-6566
Country : US
Telephone Number : 929-296-6790
Fax Number :
Provider Business Practice Location Address
First Line : 310 SAINT NICHOLAS AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11237-6566
Country : US
Telephone Number : 929-296-6790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/09/2026
Last Update Date : 02/09/2026

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Directions to “ MARY DE LA CRUZ PEREZ ” Practice Location

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