1538774427 NPI number — YOMAYRA CRUZ HERNANDEZ I PSY D.

Table of content: YOMAYRA CRUZ HERNANDEZ I PSY D. (NPI 1538774427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538774427 NPI number — YOMAYRA CRUZ HERNANDEZ I PSY D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRUZ HERNANDEZ
Provider First Name:
YOMAYRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
I
Provider Credential Text:
PSY D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1538774427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
URBANIZACION LOS CAOBOS CALLE GUARAGUAO
Provider Second Line Business Mailing Address:
1729
Provider Business Mailing Address City Name:
PONCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00716
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-372-1462
Provider Business Mailing Address Fax Number:
787-848-6334

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE RENAL CENTER OF MANATI
Provider Second Line Business Practice Location Address:
CARR. 2 KM. 47.7
Provider Business Practice Location Address City Name:
MANATI
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00674
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-854-3322
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  7335 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7335 . This is a "PSICOLIGIA CLINICA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".