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Dyane Lyn Cavagnaro-Irvine

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

This provider is enrolled in PECOS as DYANE CAVAGNARO IRVINE.

Based on the most recent information from CMS, provider Dyane Lyn Cavagnaro-Irvine is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1215472519
Provider Type
Individual
Full Name
Cavagnaro-Irvine, Dyane Lyn
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
12/23/2016
Last Updated
12/23/2016

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9360

Unlisted Fax

Mailing Location

216 Bryant Ave, Staten Island, NY 10306-3104

(718) 351-8287

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 005387-1 New York

Dyane Lyn Cavagnaro-Irvine

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Sher, Maykl

Rakvin, Magdalena

Babu, Archana

Xi, Mandy

Ingrassia, Michael Anthony

Anees, Insherah

Bello, Francelli Marie

Pallas, Shirly

Feyijinmi, Olusegun I

Calcutta, Samantha