Basic Information
Provider Information | |||||||||
NPI: | 1144339201 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FINCH CRUZ | ||||||||
FirstName: | CLARA | ||||||||
MiddleName: | NAIDINE | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | FINCH | ||||||||
OtherFirstName: | CLARA | ||||||||
OtherMiddleName: | NAIDINE | ||||||||
OtherNamePrefix: | DR. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | M.D. | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 26 LAUREL MOUNTAIN WAY | ||||||||
Address2: |   | ||||||||
City: | CALIFON | ||||||||
State: | NJ | ||||||||
PostalCode: | 078303027 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9736761000 | ||||||||
FaxNumber: | 9733957126 | ||||||||
Practice Location | |||||||||
Address1: | 385 TREMONT AVE | ||||||||
Address2: | DEPT. PATHOLOGY AND LABORATORY MEDICINE | ||||||||
City: | EAST ORANGE | ||||||||
State: | NJ | ||||||||
PostalCode: | 070181023 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9736761000 | ||||||||
FaxNumber: | 9733957126 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/30/2006 | ||||||||
LastUpdateDate: | 07/08/2007 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZH0000X | 31882 | AZ | X |   | Allopathic & Osteopathic Physicians | Pathology | Hematology | 207ZP0102X | 31882 | AZ | X |   | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.