Fredeswinda Policarpio Cruz, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

106163 Issued in NY

Practice address

4 Gadsen Place
Staten Island, NY 10314

Phone

(718) 698-3333

Fax

(718) 698-2691

NPI assigned

Oct 1, 2007

Last updated

Oct 1, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1205023546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GADSEN PLACE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-698-3333",
            "fax_number": "718-698-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GADSEN PLACE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-698-3333",
            "fax_number": "718-698-2691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "FREDESWINDA",
        "middle_name": "POLICARPIO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-01",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "MA023641",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "106163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS BLUE SH",
            "identifier": "62872",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0052638",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Cruciata
• Jennifer Crumpley, LCSW
• Esther Cruz-Hannan, PA
• Aileen Beatriz Cruz, OTR/L
• Evelyn Cruz
• Jan Ericson Cruz
• Jose L Cruz, PT
• Jovana Cruz, PROVISIONAL NCSP
• Kara Ann Cruz, LMSW
• Kim Laurie Cruz

• Pediatrics Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.