MEDICARE: ANIBAL ROMERO, D.D.S.,P.C.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	031386	NY
2	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255504569
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANIBAL ROMERO, D.D.S.,P.C.

Provider Business Mailing Address
First Line	:	4011 WARREN ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1700
Country	:	US
Telephone Number	:	718-426-3434
Fax Number	:	718-426-2114

Provider Business Practice Location Address
First Line	:	4011 WARREN ST
Second Line	:
City	:	ELMHURST
State	:	NY
Zip	:	11373-1700
Country	:	US
Telephone Number	:	718-426-3434
Fax Number	:	718-426-2114

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. ANIBAL ROMERO
Credential	:	D.D.S.
Telephone Number	:	718-426-3434

Provider Enumeration Date	:	04/08/2008
Last Update Date	:	06/19/2008

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