Provider Demographics
NPI:1104133123
Name:CRUZ, YANEZA S (MSW)
Entity type:Individual
Prefix:
First Name:YANEZA
Middle Name:S
Last Name:CRUZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 W 180TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-5849
Mailing Address - Country:US
Mailing Address - Phone:212-795-9888
Mailing Address - Fax:212-795-9899
Practice Address - Street 1:549 W 180TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-5849
Practice Address - Country:US
Practice Address - Phone:212-795-9888
Practice Address - Fax:212-795-9899
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker