Provider Demographics
NPI:1184627879
Name:ROMERO, JENNIFER R (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:R
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3394 SAXONBURG BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:GLENSHAW
Mailing Address - State:PA
Mailing Address - Zip Code:15116-3169
Mailing Address - Country:US
Mailing Address - Phone:412-767-0707
Mailing Address - Fax:412-767-0708
Practice Address - Street 1:3394 SAXONBURG BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:GLENSHAW
Practice Address - State:PA
Practice Address - Zip Code:15116-3168
Practice Address - Country:US
Practice Address - Phone:412-767-0707
Practice Address - Fax:412-767-0708
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD421212208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH92647Medicare UPIN