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General NPI Number Information
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NPI Number | 1730801432
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Entity Type | Individual
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Provider Name | NATALIE CORIN CRUZ PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2022
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 727 N BEERS ST
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City | HOLMDEL
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State | NJ
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Zip | 07733-1514
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Country | US
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Telephone | 914-310-9738
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Fax |
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Provider Business Mailing Address
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Address Line | 79 WASHINGTON AVE
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City | SOUTH AMBOY
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State | NJ
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Zip | 08879-2433
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Country | US
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Telephone | 914-310-9738
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00733400
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License Number State | NJ
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