Provider Demographics
NPI:1639163793
Name:ROMERO, DANA V (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:V
Last Name:ROMERO
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 E 102ND ST FL 5
Mailing Address - Street 2:BOX 1259
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5204
Mailing Address - Country:US
Mailing Address - Phone:212-824-7886
Mailing Address - Fax:212-202-4713
Practice Address - Street 1:17 E 102ND ST FL 5
Practice Address - Street 2:BOX 1259
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5204
Practice Address - Country:US
Practice Address - Phone:212-824-7886
Practice Address - Fax:212-202-4713
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY558428163W00000X
NYF334604363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00665274Medicare ID - Type Unspecified