MEDICARE: DR. JOSE ROMEU M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	114246	NY

General Provider Information

NPI Number	:	1023037769
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE ROMEU M.D.

Provider Business Mailing Address
First Line	:	1107 5TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-0145
Country	:	US
Telephone Number	:	212-534-6747
Fax Number	:	212-427-8417

Provider Business Practice Location Address
First Line	:	1107 5TH AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-0145
Country	:	US
Telephone Number	:	212-534-6747
Fax Number	:	212-427-8417

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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