Provider Demographics
NPI:1518402890
Name:VAZQUEZ CRUZ, JOSE MANUEL (NP)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:VAZQUEZ CRUZ
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:JOSE
Other - Middle Name:MANUEL
Other - Last Name:VAZQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1545 INWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452-2001
Mailing Address - Country:US
Mailing Address - Phone:855-681-8700
Mailing Address - Fax:718-294-4765
Practice Address - Street 1:1545 INWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2001
Practice Address - Country:US
Practice Address - Phone:855-681-8700
Practice Address - Fax:718-294-4765
Is Sole Proprietor?:No
Enumeration Date:2016-12-22
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY647833163W00000X, 163WA0400X, 163WA2000X, 163WC0400X, 163WC2100X, 163WD0400X, 163WE0003X, 163WG0000X, 163WI0600X, 163WP0808X, 163WP0809X, 163WP2201X, 163WP2201X, 163WW0000X
NY4067442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC2100XNursing Service ProvidersRegistered NurseContinence Care
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WI0600XNursing Service ProvidersRegistered NurseInfection Control
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
No163WW0000XNursing Service ProvidersRegistered NurseWound Care