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NPI Code Detail

MEDICARE: MRS. PHOEBE C.M. ROMERO PA-C

MEDICARE: MRS. PHOEBE C.M. ROMERO PA-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
1363A00000XPhysician Assistant1411TN
2363A00000XPhysician Assistant2011010509MO
3363AM0700XMedical Physician Assistant3223CT

General Provider Information

NPI Number : 1689819112
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. PHOEBE C.M. ROMERO PA-C
Provider Business Mailing Address
First Line : 39 EASTHAM BRIDGE RD
Second Line :
City : EAST HAMPTON
State : CT
Zip : 06424-1374
Country : US
Telephone Number : 615-939-2015
Fax Number :
Provider Business Practice Location Address
First Line : 136 BERLIN RD
Second Line :
City : CROMWELL
State : CT
Zip : 06416-2627
Country : US
Telephone Number : 860-378-8585
Fax Number : 860-378-8586
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2008
Last Update Date : 05/14/2015

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