Provider Demographics
NPI:1174485320
Name:PEREZ CRUZ, ELEINY J
Entity type:Individual
Prefix:
First Name:ELEINY
Middle Name:J
Last Name:PEREZ CRUZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-4013
Mailing Address - Country:US
Mailing Address - Phone:732-221-0460
Mailing Address - Fax:
Practice Address - Street 1:1371 SEABURY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3651
Practice Address - Country:US
Practice Address - Phone:718-294-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-25
Last Update Date:2025-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL358358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily