Provider Demographics
NPI:1467968545
Name:ROMERO, LENNIE (CRNP)
Entity Type:Individual
Prefix:MR
First Name:LENNIE
Middle Name:
Last Name:ROMERO
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1480
Mailing Address - Country:US
Mailing Address - Phone:570-459-1485
Mailing Address - Fax:570-459-6354
Practice Address - Street 1:1090 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1480
Practice Address - Country:US
Practice Address - Phone:570-459-1485
Practice Address - Fax:570-459-6354
Is Sole Proprietor?:No
Enumeration Date:2017-12-27
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP018355363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily