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NPI Code Detail

MEDICARE: CHARLEMAGNE DELA CRUZ

MEDICARE: CHARLEMAGNE DELA 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
1225100000XPhysical Therapist40QA01125300NJ

General Provider Information

NPI Number : 1851448583
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLEMAGNE DELA CRUZ
Provider Business Mailing Address
First Line : 230 SEA PINE DR
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-8125
Country : US
Telephone Number : 347-703-1758
Fax Number :
Provider Business Practice Location Address
First Line : 6818 DELILAH RD
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-9594
Country : US
Telephone Number : 609-453-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/04/2007
Last Update Date : 05/05/2021

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Directions to “ CHARLEMAGNE DELA CRUZ ” Practice Location

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