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NPI Code Detail

MEDICARE: DR. BRANDON CRUZ PT, DPT

MEDICARE: DR. BRANDON CRUZ PT, DPT
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
1225100000XPhysical Therapist40QA01514700NJ

General Provider Information

NPI Number : 1447684642
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRANDON CRUZ PT, DPT
Provider Business Mailing Address
First Line : 1 MACOPIN AVE
Second Line :
City : RIVERDALE
State : NJ
Zip : 07457-1609
Country : US
Telephone Number : 973-271-3368
Fax Number :
Provider Business Practice Location Address
First Line : 271 GROVE AVE STE C
Second Line :
City : VERONA
State : NJ
Zip : 07044-1729
Country : US
Telephone Number : 201-340-4846
Fax Number : 973-513-6105
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2013
Last Update Date : 07/21/2022

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