Healthcare Provider Details

I. General information

NPI: 1194977611
Provider Name (Legal Business Name): GERARDO P ROMEO MD, DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 CHESTNUT ST
SPRINGFIELD MA
01199-5000
US

IV. Provider business mailing address

759 CHESTNUT ST
SPRINGFIELD MA
01199-0001
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-0000
  • Fax:
Mailing address:
  • Phone: 413-794-0000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number055347
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number2901600443
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number3018417
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: