Provider Demographics
NPI:1780757708
Name:KAYUME, RAYMOND RIAD (DC)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:RIAD
Last Name:KAYUME
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13313 103RD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2305
Mailing Address - Country:US
Mailing Address - Phone:718-843-9827
Mailing Address - Fax:718-843-6205
Practice Address - Street 1:13313 103RD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-2305
Practice Address - Country:US
Practice Address - Phone:718-843-9827
Practice Address - Fax:718-843-6205
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010357111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU91577Medicare UPIN
NY05380Medicare ID - Type Unspecified