Healthcare Provider Details

I. General information

NPI: 1851577027
Provider Name (Legal Business Name): ROMINA LORELEY BARRAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2008
Last Update Date: 03/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

909 WALNUT ST APT 1006
KANSAS CITY MO
64106-2018
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3000
  • Fax:
Mailing address:
  • Phone: 313-801-3103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number2012012823
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: