Provider Demographics
NPI:1164233177
Name:CRUZATTY, XAVIER ANDRES ANDRES
Entity type:Individual
Prefix:
First Name:XAVIER ANDRES
Middle Name:ANDRES
Last Name:CRUZATTY
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 1:7 WOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-5124
Mailing Address - Country:US
Mailing Address - Phone:646-874-1498
Mailing Address - Fax:
Practice Address - Street 1:4 MEDICAL PARK DR STE B
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3572
Practice Address - Country:US
Practice Address - Phone:877-410-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051222225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist