Basic Information
| Provider Information | |||||||||
| NPI: | 1083945331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CRUZ | ||||||||
| FirstName: | JOCELYN | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5140 59TH ST | ||||||||
| Address2: | |||||||||
| City: | WOODSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113777413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186392931 | ||||||||
| FaxNumber: | 7183340399 | ||||||||
| Practice Location | |||||||||
| Address1: | 5140 59TH ST | ||||||||
| Address2: | |||||||||
| City: | WOODSIDE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113777413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186392931 | ||||||||
| FaxNumber: | 7183340399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/27/2010 | ||||||||
| LastUpdateDate: | 03/18/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | P73944 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.