Healthcare Provider Details

I. General information

NPI: 1861923641
Provider Name (Legal Business Name): YANIBETH CRUZ ORTIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 SYCAMORE AVE STE 2A
LITTLE SILVER NJ
07739-1248
US

IV. Provider business mailing address

34 SYCAMORE AVE STE 2A
LITTLE SILVER NJ
07739-1248
US

V. Phone/Fax

Practice location:
  • Phone: 732-747-9310
  • Fax:
Mailing address:
  • Phone: 732-747-9310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number23442
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number25MA12661100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: