Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 56768 | CT |
NPI | 1346521531 |
---|---|
Provider Name | Lisa Michelle Cruz-Aviles |
First Address | New Haven, CT 06515-4429 |
Second Address | New Haven, CT 06510-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2011 |
Last Update Date | 15/06/2020 |