Provider Demographics
NPI:1679389308
Name:UMAYAN, CIRILO AGUSTIN JR (FNP)
Entity type:Individual
Prefix:MR
First Name:CIRILO
Middle Name:AGUSTIN
Last Name:UMAYAN
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 WESTLAKE CT
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-1415
Mailing Address - Country:US
Mailing Address - Phone:646-220-1638
Mailing Address - Fax:
Practice Address - Street 1:2325 WESTLAKE CT
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-1415
Practice Address - Country:US
Practice Address - Phone:646-220-1638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-07
Last Update Date:2025-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354639363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily