Provider Information for 1568887461
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JEANIE ROMERO
Sex: Female
NPI: 1568887461
Last Updated: 2021-03-30
Certification Date: 2021-03-30
Certification Date: 2021-03-30
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1568887461 | ||||||||||||||
| Enumeration Date | 2014-02-28 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 375 E 205TH ST APT 3E BRONX, NY 10467-4423 United States Phone: 917-544-0612 | Fax: | ||||||||||||||
| Primary Practice Address | 375 E 205TH ST APT 3E BRONX, NY 10467-4423 United States Phone: 917-544-0612 | Fax: | ||||||||||||||
| Secondary Practice Address(es) | 755 NEW YORK AVE STE 230 | ||||||||||||||
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