Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 26NO06567300 | NJ |
NPI | 1003832510 |
---|---|
Provider Name | Cynthia E Cross |
First Address | Newark, NJ 07189-0001 |
Second Address | Summit, NJ 07901-3533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2006 |
Last Update Date | 08/07/2007 |