Provider Demographics
NPI:1194235010
Name:CAYAMCELA, KARLA M
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:M
Last Name:CAYAMCELA
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 1:710 MILL ST UNIT H3
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-5306
Mailing Address - Country:US
Mailing Address - Phone:973-759-1494
Mailing Address - Fax:
Practice Address - Street 1:1060 BROAD ST
Practice Address - Street 2:BAESMENT
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07018
Practice Address - Country:US
Practice Address - Phone:855-465-7626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00286800225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant