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NPI Code Detail

MEDICARE: MANUEL ROMO CRISOSTOMO

MEDICARE:   MANUEL  ROMO CRISOSTOMO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1043168826
Entity Type Code : Individual
Provider Name (Legal Business Name) : MANUEL ROMO CRISOSTOMO
Provider Business Mailing Address
First Line : 350 ENGLE ST
Second Line :
City : ENGLEWOOD
State : NJ
Zip : 07631-1898
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 350 ENGLE ST
Second Line :
City : ENGLEWOOD
State : NJ
Zip : 07631-1898
Country : US
Telephone Number : 201-894-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2026
Last Update Date : 03/18/2026

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Directions to “ MANUEL ROMO CRISOSTOMO ” Practice Location

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