Provider Demographics
NPI:1578199899
Name:ROMERO, LYDIA MARY
Entity Type:Individual
Prefix:
First Name:LYDIA
Middle Name:MARY
Last Name:ROMERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3733 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:CO
Mailing Address - Zip Code:80620-2404
Mailing Address - Country:US
Mailing Address - Phone:970-397-4962
Mailing Address - Fax:
Practice Address - Street 1:3733 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:CO
Practice Address - Zip Code:80620-2404
Practice Address - Country:US
Practice Address - Phone:970-397-4962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker