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General NPI Number Information
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NPI Number | 1679206569
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Entity Type | Individual
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Provider Name | MICHAEL CRUZ
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Gender | Male
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Dates
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Enumeration Date | 07/07/2022
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Last Update Date | 10/08/2025
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Provider Practice Location Address
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Address Line | 136 MADISON AVE FL 5
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City | NEW YORK
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State | NY
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Zip | 10016-6796
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Country | US
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Telephone | 212-828-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SEDGWICK AVE
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City | YONKERS
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State | NY
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Zip | 10705-4621
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Country | US
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Telephone | 914-610-8267
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 116148-01
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 015674
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License Number State | NY
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