Healthcare Provider Details

I. General information

NPI: 1912246703
Provider Name (Legal Business Name): KATHLEEN A. ROMERO AUDIOLOGY P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 CEDAR ST SE
ALBUQUERQUE NM
87106-3927
US

IV. Provider business mailing address

415 CEDAR ST SE
ALBUQUERQUE NM
87106-3927
US

V. Phone/Fax

Practice location:
  • Phone: 505-235-5786
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number4554
License Number StateNM

VIII. Authorized Official

Name: DR. KATHLEEN AMY ROMERO
Title or Position: AUDIOLOGIST/OWNER
Credential: AUD
Phone: 505-235-5786