Healthcare Provider Details

I. General information

NPI: 1720068406
Provider Name (Legal Business Name): PETER STARRATT ROMEYN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 03/03/2021
Certification Date: 03/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 SAYBROOK RD
MIDDLETOWN CT
06457-4711
US

IV. Provider business mailing address

22 PATTERSON LN
DURHAM CT
06422-2418
US

V. Phone/Fax

Practice location:
  • Phone: 603-582-8508
  • Fax: 860-358-8698
Mailing address:
  • Phone: 860-349-6941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number038347
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number038347
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number038347
License Number StateCT
# 4
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number038347
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: