Provider Demographics
NPI:1598755332
Name:ROMERO, JAVIER M (MD)
Entity Type:Individual
Prefix:DR
First Name:JAVIER
Middle Name:M
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-726-8789
Mailing Address - Fax:617-726-8395
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:GRB 246
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-8789
Practice Address - Fax:617-726-8395
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2222912085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA469979OtherTUFTS HEALTH PLAN
MAJ28233OtherBCBS MA
MA2087651Medicaid
MAJ28233OtherBCBS MA
I20512Medicare UPIN