Provider Demographics
NPI:1417092610
Name:CYVAS, EDMUND VYTENIS (MD)
Entity Type:Individual
Prefix:MR
First Name:EDMUND
Middle Name:VYTENIS
Last Name:CYVAS
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 1:482 HENRY ST.
Mailing Address - Street 2:#4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-3098
Mailing Address - Country:US
Mailing Address - Phone:718-875-3155
Mailing Address - Fax:718-859-5708
Practice Address - Street 1:18 E. 16TH ST.
Practice Address - Street 2:SUITE 503
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3111
Practice Address - Country:US
Practice Address - Phone:718-875-3155
Practice Address - Fax:718-859-5708
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1539522084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry