Provider Demographics
NPI:1265487334
Name:ROMERO, REY R (MD)
Entity Type:Individual
Prefix:DR
First Name:REY
Middle Name:R
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-2139 FT WEAVER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-680-0558
Mailing Address - Fax:808-680-0500
Practice Address - Street 1:91-2139 FORT WEAVER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3607
Practice Address - Country:US
Practice Address - Phone:808-680-0558
Practice Address - Fax:808-680-0500
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD127022084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA80320Medicare UPIN