Healthcare Provider Details

I. General information

NPI: 1194680744
Provider Name (Legal Business Name): AIMEE FERNANDEZ CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 TEANECK RD
TEANECK NJ
07666-4245
US

IV. Provider business mailing address

3 UNIVERSITY PLZ STE 205
HACKENSACK NJ
07601-6208
US

V. Phone/Fax

Practice location:
  • Phone: 201-833-7208
  • Fax: 201-379-5611
Mailing address:
  • Phone: 201-833-3599
  • Fax: 201-227-6207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ15487400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: