Provider Demographics
NPI:1790457208
Name:PAYUMO, KESTER KING JAVATE (MSN, RN, FNP-C, CEN)
Entity Type:Individual
Prefix:MR
First Name:KESTER KING
Middle Name:JAVATE
Last Name:PAYUMO
Suffix:
Gender:M
Credentials:MSN, RN, FNP-C, CEN
Other - Prefix:
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Mailing Address - Street 1:531 AVENUE E
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3926
Mailing Address - Country:US
Mailing Address - Phone:201-407-5221
Mailing Address - Fax:
Practice Address - Street 1:305 E 86TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4702
Practice Address - Country:US
Practice Address - Phone:201-407-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-03
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY348070363LF0000X
NJ26NR18592200163W00000X
NY675482163WE0003X
NJ26NJ01206800363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No163WE0003XNursing Service ProvidersRegistered NurseEmergency