Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207PP0204X | Pediatric Emergency Physician | 272450 | NY |
Y | 207PP0204X | Pediatric Emergency Physician | T4899 | TX |
NPI | 1619132073 |
---|---|
Provider Name | Jacques Stanley Cayo |
First Address | Rochester, NY 14617-5504 |
Second Address | San Antonio, TX 78207-3108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2008 |
Last Update Date | 08/02/2022 |