Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 431527 | NY |
Y | 363LA2100X | Nurse Practitioner - Acute Care | 431527 | NY |
NPI | 1053963777 |
---|---|
Provider Name | Ms. Lauren Nicolle Dela Cruz |
First Address | Elmhurst, NY 11373-5838 |
Second Address | New York, NY 10029-6508 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2019 |
Last Update Date | 27/10/2019 |