Healthcare Provider Details

I. General information

NPI: 1790839124
Provider Name (Legal Business Name): DORIS RUTH ROMERO D.O.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 04/03/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

826 CAMINO DE MONTE REY STE A3
SANTA FE NM
87505-3961
US

IV. Provider business mailing address

406 GOLDMINE RD
CERRILLOS NM
87010-9717
US

V. Phone/Fax

Practice location:
  • Phone: 505-670-1841
  • Fax:
Mailing address:
  • Phone: 505-670-1841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number363
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: