Provider Demographics
NPI:1982258844
Name:DE LA CRUZ, SOFIA VIOLETA (MD)
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:VIOLETA
Last Name:DE LA CRUZ
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:1783 ROUTE 9 STE 201
Practice Address - Street 2:
Practice Address - City:HALFMOON
Practice Address - State:NY
Practice Address - Zip Code:12065-2466
Practice Address - Country:US
Practice Address - Phone:518-371-9355
Practice Address - Fax:518-373-9139
Is Sole Proprietor?:No
Enumeration Date:2019-07-30
Last Update Date:2024-11-08
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Provider Licenses
StateLicense IDTaxonomies
NY333177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine