Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 0101250037 | VA |
Y | 207X00000X | Orthopaedic Surgeon | 14940 | RI |
N | 207X00000X | Orthopaedic Surgeon | 25MA09385400 | NJ |
N | 207X00000X | Orthopaedic Surgeon | MD450545 | PA |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | MT205521 | PA |
NPI | 1568646800 |
---|---|
Provider Name | Aristides Ignacio Cruz JR. |
First Address | Providence, RI 02901-1119 |
Second Address | East Providence, RI 02914-5375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2007 |
Last Update Date | 12/02/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1568646800 | (05) | VA |