Jillian Cavuto
Individual provider Active NPI Specialist · Howard Beach, NY
NPI 1962991737 · NPPES record last updated May 7, 2018
Key facts
- NPI
- 1962991737
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 2604047 (NY)
- Practice address
- 15616 99TH St
Howard Beach, NY 11414-2859 - Phone
- (646) 523-8867
- NPI assigned
- May 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2604047 | NY | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2604047 | NY | Yes |
Addresses
Primary practice location
15616 99TH St
Howard Beach, NY 11414-2859
Mailing address
15616 99TH St
Howard Beach, NY 11414-2859
Other providers in Howard Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.