Basic Information
| Provider Information | |||||||||
| NPI: | 1639455512 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | QAYYUM | ||||||||
| FirstName: | ROOMANA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 EAST 87TH STREET | ||||||||
| Address2: | APT 12 L | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10128 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3474418202 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1090 AMSTERDAM AVENUE | ||||||||
| Address2: | 16 A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10025 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125235089 | ||||||||
| FaxNumber: | 2125231685 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2011 | ||||||||
| LastUpdateDate: | 08/08/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 279679 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.