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1104237627
JAN ERICSON CRUZ
STATEN ISLAND, NY
NPI
1104237627
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103K00000X Behavior Analyst
(Licence: NY 1-12-10214)
Enumeration Date
2014-05-19
Last Update Date
2014-05-29
Business Address
Mr. JAN ERICSON CRUZ
150 GRANITE AVE
STATEN ISLAND, NY 10303-2718
Phone number: 718-816-1422
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Mailing Address
Mr. JAN ERICSON CRUZ
150 GRANITE AVE
STATEN ISLAND, NY 10303-2718
Phone number: 718-816-1422
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