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General NPI Number Information
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NPI Number | 1669725180
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Entity Type | Organization
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Legal Business Name | DELACRUZ&DELACRUZ MEDICAL SUPPLY
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Dates
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Enumeration Date | 10/22/2012
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Last Update Date | 10/22/2012
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Provider Practice Location Address
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Address Line | 258 E 1ST ST
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City | CLIFTON
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State | NJ
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Zip | 07011-1643
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Country | US
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Telephone | 973-510-1101
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Fax |
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Provider Business Mailing Address
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Address Line | 258 E 1ST ST
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City | CLIFTON
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State | NJ
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Zip | 07011-1643
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Country | US
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Telephone | 973-510-1101
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | ANA VIRGINIA DE LA CRUZ
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Credential |
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Telephone | 973-510-1101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State | NJ
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