Individual provider Active NPI

Cheryll Dane Cruz Cruz, OTR/L

  • Pediatric Occupational Therapist
  • Long Island City, NY
National Provider Identifier
1689986812
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
014766-1 Issued in NY
Practice address
3310 Queens Blvd
Suite 301
Long Island City, NY 11101-2302
Phone
(718) 593-4121
Fax
(718) 268-2646
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 014766-1 NY Primary

Addresses

Primary practice location

3310 Queens Blvd
Suite 301
Long Island City, NY 11101-2302

Mailing address

3310 Queens Blvd
Suite 301
Long Island City, NY 11101-2302
Phone (718) 593-4121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014766-1NYMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1689986812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 QUEENS BLVD",
            "address_2": "SUITE 301",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012302",
            "telephone_number": "718-593-4121",
            "fax_number": "718-268-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 QUEENS BLVD",
            "address_2": "SUITE 301",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012302",
            "telephone_number": "718-593-4121",
            "fax_number": "718-268-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRUZ",
        "first_name": "CHERYLL DANE",
        "middle_name": "CRUZ",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "014766-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.