MEDICARE: WEST SHORE NEUROLOGY LLC

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1427187335
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST SHORE NEUROLOGY LLC

Provider Business Mailing Address
First Line	:	91-2139 FORT WEAVER RD STE 210
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3609
Country	:	US
Telephone Number	:	808-680-0558
Fax Number	:

Provider Business Practice Location Address
First Line	:	91-2139 FORT WEAVER RD STE 210
Second Line	:
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3609
Country	:	US
Telephone Number	:	808-680-0558
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAY R ROMERO
Credential	:	M.D
Telephone Number	:	808-680-0558

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	08/22/2020

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