Healthcare Provider Details

I. General information

NPI: 1699614941
Provider Name (Legal Business Name): ZENAIDA IVETTE CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2932 WILKINSON AVE
BRONX NY
10461-4004
US

IV. Provider business mailing address

3421 BRUCKNER BLVD
BRONX NY
10461-5206
US

V. Phone/Fax

Practice location:
  • Phone: 347-621-2185
  • Fax: 516-821-8956
Mailing address:
  • Phone: 718-722-0531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number131028
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: