Healthcare Provider Details

I. General information

NPI: 1396047957
Provider Name (Legal Business Name): PORFINIO JAMES ROMERO CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: P. JAMES ROMERO CFNP

II. Dates (important events)

Enumeration Date: 12/02/2010
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 HOMESTEAD RD NE STE 201
ALBUQUERQUE NM
87110
US

IV. Provider business mailing address

5310 HOMESTEAD RD NE STE 201
ALBUQUERQUE NM
87110-1524
US

V. Phone/Fax

Practice location:
  • Phone: 505-237-2574
  • Fax: 505-272-2240
Mailing address:
  • Phone: 505-237-2574
  • Fax: 505-272-2240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-01672
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberCNP-01672
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: