Healthcare Provider Details

I. General information

NPI: 1316169071
Provider Name (Legal Business Name): ROMINA T YEE RD, LD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROMINA T TORIO RD, LD

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14519 DETROIT AVE
LAKEWOOD OH
44107-4316
US

IV. Provider business mailing address

PO BOX 951101
CLEVELAND OH
44193-0005
US

V. Phone/Fax

Practice location:
  • Phone: 216-521-4200
  • Fax:
Mailing address:
  • Phone: 440-879-0081
  • Fax: 440-879-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberLD-2452
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: