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NPI Code Detail

MEDICARE: DR. KRISTINE MICHELLE CRUZ MD

MEDICARE: DR. KRISTINE MICHELLE CRUZ MD
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
1208600000XSurgery Physician047528CT
2208600000XSurgery Physician246013NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1780841569
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTINE MICHELLE CRUZ MD
Provider Business Mailing Address
First Line : 1000 ZECKENDORF BLVD
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-2133
Country : US
Telephone Number : 516-542-6880
Fax Number : 516-542-5556
Provider Business Practice Location Address
First Line : 1000 ZECKENDORF BLVD
Second Line :
City : GARDEN CITY
State : NY
Zip : 11530-2133
Country : US
Telephone Number : 516-542-6880
Fax Number : 516-542-5556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2008
Last Update Date : 09/21/2010

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