Cruz, Ernesto Santiago

Cruz, Ernesto Santiago is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Cruz, Ernesto Santiago can be contacted via phone (215) 707-3646.

Contact Information

Primary practice address
3401 N Broad St Philadelphia PA 19140-5103
Phone: (215) 707-3646
Fax: (215) 707-3644
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD053680L Pennsylvania

Profile Details

NPI number 1811967102
LBN Legal business name Cruz, Ernesto Santiago
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 26th, 2006
Last updated Mar 27th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1811967102 NPPES
Pennsylvania MEDICAID 01646061

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