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General NPI Number Information
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NPI Number | 1871697292
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Entity Type | Individual
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Provider Name | AZUCENA C. CRUZ REY MD
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Gender | Female
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Dates
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Enumeration Date | 09/08/2006
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 327 BEACH 19TH ST # CP 4
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-4423
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Country | US
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Telephone | 718-869-7248
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Fax |
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Provider Business Mailing Address
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Address Line | 150 LONG DR
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City | HEMPSTEAD
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State | NY
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Zip | 11550-4717
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Country | US
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Telephone | 516-489-2287
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 114201
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License Number State | NY
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