Healthcare Provider Details

I. General information

NPI: 1861202004
Provider Name (Legal Business Name): SHAQUIRA ROSALES CRUZ BS, HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 WASHINGTON RD STE 3B
MC MURRAY PA
15317-2543
US

IV. Provider business mailing address

619 CALVERT AVE
PITTSBURGH PA
15227-3834
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-0958
  • Fax:
Mailing address:
  • Phone: 813-777-4271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberF03945
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: