Provider Demographics
NPI:1073014551
Name:CRUZ, MONICA (MS SPED)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 CLYMER ST APT 6D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-6769
Mailing Address - Country:US
Mailing Address - Phone:347-751-9110
Mailing Address - Fax:
Practice Address - Street 1:111 CLYMER ST APT 6D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-6769
Practice Address - Country:US
Practice Address - Phone:347-751-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-21
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist