Edgar Cruz Davila, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

318406-01 Issued in NY

Practice address

3711 Queens Blvd
Long Island City, NY 11101-1725

Phone

(718) 606-3863

NPI assigned

Mar 11, 2019

Last updated

Jul 25, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1619435559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7166 PARSONS BLVD APT 2A",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113654506",
            "telephone_number": "407-866-4658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3711 QUEENS BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111011725",
            "telephone_number": "718-606-3863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ DAVILA",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-11",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "318406",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "318406-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilona Eva Criner, PMHNP, DNP
• Matthew D Croley
• Keisha Latoya Crossgill, RN, BSN
• Crossland Transportation Management Corp
• Tara Olideyka Crossman
• Epiphany Chikara Cruz-Maxwell, RN
• Arlenny Cruz
• Becky A Cruz, LPN
• Cheryll Dane Cruz Cruz, OTR/L
• Fernando Guarnizo Cuartas

• Internal Medicine Physician in Long Island City, NY
• Providers in Long Island City, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.