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NPI Code Detail

MEDICARE: SUSAN ROMEO MS, RN

MEDICARE: SUSAN ROMEO MS, RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse PractitionerF380713NY
2163W00000XRegistered Nurse380713NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1F380713OTHERNYNEW YORK STATE LICENSE
26687718OTHERNYNURSE PRACTITIONER IN PEDIATRICS, INACTIVE

General Provider Information

NPI Number : 1477669711
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ROMEO MS, RN
Provider Business Mailing Address
First Line : 8200 SENECA TPKE
Second Line :
City : CLINTON
State : NY
Zip : 13323-1027
Country : US
Telephone Number : 315-725-0403
Fax Number :
Provider Business Practice Location Address
First Line : 8200 SENECA TPKE
Second Line :
City : CLINTON
State : NY
Zip : 13323-1027
Country : US
Telephone Number : 315-725-0403
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2006
Last Update Date : 04/24/2013

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