Provider Demographics
NPI:1366588311
Name:CRUZ, RAYMOND
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:CRUZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 NIAGARA STREE
Mailing Address - Street 2:DRUG & ALCOHOL ABUSE SERVICES PROGRAM
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213
Mailing Address - Country:US
Mailing Address - Phone:716-883-5344
Mailing Address - Fax:716-884-1758
Practice Address - Street 1:951 NIAGARA STREE
Practice Address - Street 2:DRUG & ALCOHOL ABUSE SERVICES PROGRAM
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213
Practice Address - Country:US
Practice Address - Phone:716-883-5344
Practice Address - Fax:716-884-1758
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)