Healthcare Provider Details

I. General information

NPI: 1023075769
Provider Name (Legal Business Name): ROMEO A TIU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 UNION AVE SUITE 206
IRVINGTON NJ
07111-3277
US

IV. Provider business mailing address

40 UNION AVE SUITE 206
IRVINGTON NJ
07111-3277
US

V. Phone/Fax

Practice location:
  • Phone: 973-375-5500
  • Fax: 973-375-5561
Mailing address:
  • Phone: 973-375-5500
  • Fax: 973-375-5561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMA27415
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: