Provider Demographics
NPI:1184674103
Name:SAINT CYRUS, EVENS (MD)
Entity Type:Individual
Prefix:
First Name:EVENS
Middle Name:
Last Name:SAINT CYRUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 MARCUS DR
Mailing Address - Street 2:PROVIDER ENROLLMENT
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-4230
Mailing Address - Country:US
Mailing Address - Phone:631-391-8371
Mailing Address - Fax:631-454-4163
Practice Address - Street 1:8900 VAN WYCK
Practice Address - Street 2:JAMAICA ANESTHESIA ASSOCIATES PC
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11418
Practice Address - Country:US
Practice Address - Phone:718-206-6088
Practice Address - Fax:718-206-6532
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY169274207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01566545Medicaid
NY01566545Medicaid
NY0166AFMedicare PIN