Healthcare Provider Details

I. General information

NPI: 1841672862
Provider Name (Legal Business Name): MATTHEW GEROMI, D.O., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 WIGWAM PKWY SUITE 100
HENDERSON NV
89074-8162
US

IV. Provider business mailing address

1090 WIGWAM PKWY SUITE 100
HENDERSON NV
89074-8162
US

V. Phone/Fax

Practice location:
  • Phone: 702-454-0201
  • Fax:
Mailing address:
  • Phone: 702-454-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MATTHEW GEROMI
Title or Position: PSYCHIATRIST
Credential: D.O.
Phone: 702-454-0201