Provider Demographics
NPI:1194818849
Name:CAYANAN, ROMEO SUBA (NP)
Entity type:Individual
Prefix:MR
First Name:ROMEO
Middle Name:SUBA
Last Name:CAYANAN
Suffix:
Gender:M
Credentials:NP
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Mailing Address - Street 1:60 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:125-452-4002
Mailing Address - Fax:212-463-8411
Practice Address - Street 1:36-11 21ST ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11106-4505
Practice Address - Country:US
Practice Address - Phone:718-482-7772
Practice Address - Fax:718-482-9648
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF302331363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NY00330128Medicare ID - Type Unspecified