MEDICARE: VERONICA C CRUZ-MARTINEZ LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	106H00000X	Marriage & Family Therapist	T2273	OR
3	106H00000X	Marriage & Family Therapist	37FI00198400	NJ

General Provider Information

NPI Number	:	1194137570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERONICA C CRUZ-MARTINEZ LMFT

Provider Business Mailing Address
First Line	:	197 W NEWELL AVE
Second Line	:
City	:	RUTHERFORD
State	:	NJ
Zip	:	07070-2241
Country	:	US
Telephone Number	:	510-289-9854
Fax Number	:

Provider Business Practice Location Address
First Line	:	1050 WALL ST W STE 310
Second Line	:
City	:	LYNDHURST
State	:	NJ
Zip	:	07071-3615
Country	:	US
Telephone Number	:	408-294-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2014
Last Update Date	:	07/24/2023

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