Healthcare Provider Details

I. General information

NPI: 1780598920
Provider Name (Legal Business Name): JOHNANDREW CYPRESS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

435 MAIN ST APT 323
HACKENSACK NJ
07601-6041
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ15674000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: