Provider Demographics
NPI:1639455512
Name:QAYYUM, ROOMANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ROOMANA
Middle Name:
Last Name:QAYYUM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 EAST 87TH STREET
Mailing Address - Street 2:APT 12 L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128
Mailing Address - Country:US
Mailing Address - Phone:347-441-8202
Mailing Address - Fax:
Practice Address - Street 1:1090 AMSTERDAM AVENUE
Practice Address - Street 2:16 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025
Practice Address - Country:US
Practice Address - Phone:212-523-5089
Practice Address - Fax:212-523-1685
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2796792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry