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General NPI Number Information
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NPI Number | 1790457208
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Entity Type | Individual
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Provider Name | KESTER KING JAVATE PAYUMO MSN, RN, FNP-C, CEN
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Gender | Male
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Dates
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Enumeration Date | 10/03/2021
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Last Update Date | 10/18/2021
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Provider Practice Location Address
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Address Line | 305 E 86TH ST
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City | NEW YORK
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State | NY
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Zip | 10028-4702
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Country | US
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Telephone | 201-407-5221
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Fax |
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Provider Business Mailing Address
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Address Line | 531 AVENUE E
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City | BAYONNE
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State | NJ
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Zip | 07002-3926
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Country | US
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Telephone | 201-407-5221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 348070
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 26NR18592200
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 675482
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ01206800
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License Number State | NJ
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