MEDICARE: STEPHANIE CRUZ

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1407440282
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE CRUZ

Provider Business Mailing Address
First Line	:	120 E 36TH ST STE 1E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3423
Country	:	US
Telephone Number	:	212-532-3333
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 E 36TH ST STE 1E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-3423
Country	:	US
Telephone Number	:	212-532-3333
Fax Number	:

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

Provider Enumeration Date	:	02/23/2021
Last Update Date	:	02/23/2021

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Directions to “ STEPHANIE CRUZ ” Practice Location

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