Provider Demographics
NPI:1427187335
Name:WEST SHORE NEUROLOGY LLC
Entity Type:Organization
Organization Name:WEST SHORE NEUROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-680-0558
Mailing Address - Street 1:91-2139 FORT WEAVER RD STE 210
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3609
Mailing Address - Country:US
Mailing Address - Phone:808-680-0558
Mailing Address - Fax:
Practice Address - Street 1:91-2139 FORT WEAVER RD STE 210
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3609
Practice Address - Country:US
Practice Address - Phone:808-680-0558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101161Medicare ID - Type Unspecified