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General NPI Number Information
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NPI Number | 1972040848
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Entity Type | Organization
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Legal Business Name | PHYCINITY PLLC
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Dates
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Enumeration Date | 01/30/2017
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Last Update Date | 11/30/2025
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Provider Practice Location Address
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Address Line | 2277 NC 24-87
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City | CAMERON
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State | NC
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Zip | 28326-6687
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Country | US
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Telephone | 919-373-3636
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Fax | 919-867-3493
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Provider Business Mailing Address
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Address Line | 450 CARTHAGE ST UNIT 158
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City | CAMERON
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State | NC
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Zip | 28326-5106
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Country | US
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Telephone | 919-373-3636
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Fax | 919-867-3493
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Authorized Official
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Title or Position | CMO
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Name | DR. OMAR LEONEL CABAN
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Credential | M.D.
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Telephone | 919-373-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 216754
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 216754
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License Number State | NC
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