Provider Demographics
NPI:1093020810
Name:CAYABYAB, RAYMOND MARTIN ESPANO
Entity Type:Individual
Prefix:
First Name:RAYMOND MARTIN
Middle Name:ESPANO
Last Name:CAYABYAB
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:N/A
Mailing Address - Street 1:198 TARBELL AVE
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06779-1622
Mailing Address - Country:US
Mailing Address - Phone:203-706-2385
Mailing Address - Fax:
Practice Address - Street 1:198 TARBELL AVE
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:CT
Practice Address - Zip Code:06779-1622
Practice Address - Country:US
Practice Address - Phone:203-706-2385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT007660124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist