Healthcare Provider Details

I. General information

NPI: 1952901217
Provider Name (Legal Business Name): YINA ELIZABETH CRUZ PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2020
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 STATE ROUTE 23
WAYNE NJ
07470-7516
US

IV. Provider business mailing address

1536 STATE ROUTE 23 STE 1080
WAYNE NJ
07470-7516
US

V. Phone/Fax

Practice location:
  • Phone: 833-519-1327
  • Fax:
Mailing address:
  • Phone: 833-519-1327
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number26NJ01143400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number26NJ01143400
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number403344
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number26NJ01143400
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number26NJ01143400
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number403344
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number403344
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number403344
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: