MEDICARE: RYAN M. ROMEISER 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	207P00000X	Emergency Medicine Physician	235903	NY
2	207P00000X	Emergency Medicine Physician	A105987	CA

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	:	1376508010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN M. ROMEISER M.D.

Provider Business Mailing Address
First Line	:	1648 CEDAR ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1029
Country	:	US
Telephone Number	:	646-271-7494
Fax Number	:

Provider Business Practice Location Address
First Line	:	1648 CEDAR ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1029
Country	:	US
Telephone Number	:	646-271-7494
Fax Number	:

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	12/19/2017

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