Healthcare Provider Details

I. General information

NPI: 1083351837
Provider Name (Legal Business Name): CARLOS CRUZ-PEREZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2022
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 PARSONS BLVD
FLUSHING NY
11355-2205
US

IV. Provider business mailing address

450 CLARKSON AVE
BROOKLYN NY
11203-2012
US

V. Phone/Fax

Practice location:
  • Phone: 718-670-5766
  • Fax:
Mailing address:
  • Phone: 718-245-3318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number340849
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: