MEDICARE: MS. YINA ELIZABETH CRUZ PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	403344	NY
2	2084P0805X	Geriatric Psychiatry Physician	403344	NY
3	2084P0804X	Child & Adolescent Psychiatry Physician	403344	NY

General Provider Information

NPI Number	:	1952901217
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. YINA ELIZABETH CRUZ PMHNP

Provider Business Mailing Address
First Line	:	1536 STATE ROUTE 23 STE 1080
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-7516
Country	:	US
Telephone Number	:	833-519-1327
Fax Number	:

Provider Business Practice Location Address
First Line	:	1536 STATE ROUTE 23
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-7516
Country	:	US
Telephone Number	:	833-519-1327
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2020
Last Update Date	:	10/24/2025

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