Provider Demographics
NPI:1437248580
Name:ROMEROCACES, GLORIA MARCELO (MD)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:MARCELO
Last Name:ROMEROCACES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GLORIA
Other - Middle Name:MARCELO
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1 ADRIAN WAY
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1452
Mailing Address - Country:US
Mailing Address - Phone:201-262-1867
Mailing Address - Fax:
Practice Address - Street 1:1200 RIVER AVE BLDG 10
Practice Address - Street 2:LAKEWOOD
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5657
Practice Address - Country:US
Practice Address - Phone:732-901-7575
Practice Address - Fax:732-901-1555
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY188666-1207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology