Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 25MA11088500 | NJ |
N | 2080P0208X | Pediatric Infectious Diseases | 25MA11088500 | NJ |
NPI | 1609253079 |
---|---|
Provider Name | Dr. Mariawy Riollano Cruz |
First Address | Neptune, NJ 07753 |
Second Address | Neptune, NJ 07753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2015 |
Last Update Date | 03/08/2021 |