Healthcare Provider Details

I. General information

NPI: 1073492575
Provider Name (Legal Business Name): YASIN SAYED CRUZ BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 DIVISION ST STE 501
SOMERVILLE NJ
08876-2944
US

IV. Provider business mailing address

50 DIVISION ST STE 501
SOMERVILLE NJ
08876-2944
US

V. Phone/Fax

Practice location:
  • Phone: 201-688-3608
  • Fax: 908-430-8042
Mailing address:
  • Phone: 201-688-3608
  • Fax: 908-430-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00266300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: