Surijdei Amanda Decruiz, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

12306 97TH Ave
South Richmond Hill, NY 11419-1402

Phone

(347) 314-6501

NPI assigned

Oct 24, 2019

Last updated

Oct 24, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1932742723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12306 97TH AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191402",
            "telephone_number": "347-314-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12306 97TH AVE",
            "city": "SOUTH RICHMOND HILL",
            "state": "NY",
            "postal_code": "114191402",
            "telephone_number": "347-314-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECRUIZ",
        "first_name": "SURIJDEI",
        "middle_name": "AMANDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victor Manuel Cotto, OTA
• CPW Pharma Inc. (CPW Pharmacy)
• Meher P Daruwalla
• Sarah Lindsay Davison
• Shamilla Debideen
• Julieta A Deguzman, MD
• Devicka Persaud Medical PC
• DGN Family Medicine, PLLC,
• Bakthavatsalu Dhama, RPH
• Pallab Kumar Dhar

• Student in an Organized Health Care Education/Training Program in South Richmond Hill, NY
• Providers in South Richmond Hill, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.