Provider Demographics
NPI:1578377750
Name:CRUCES, GEORGE LORENZO (DC)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:LORENZO
Last Name:CRUCES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 STOKES ST
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-1630
Mailing Address - Country:US
Mailing Address - Phone:732-298-2411
Mailing Address - Fax:
Practice Address - Street 1:602 CANDLEWOOD CMNS
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-2173
Practice Address - Country:US
Practice Address - Phone:732-901-3001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00810600111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor