Provider Demographics
NPI:1699023036
Name:PLEW, MONICA ROSE ROMERO (PT)
Entity Type:Individual
Prefix:DR
First Name:MONICA ROSE
Middle Name:ROMERO
Last Name:PLEW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2714 BANYAN WAY
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455-1641
Mailing Address - Country:US
Mailing Address - Phone:805-720-3998
Mailing Address - Fax:
Practice Address - Street 1:1604 W 18TH ST
Practice Address - Street 2:
Practice Address - City:PORTALES
Practice Address - State:NM
Practice Address - Zip Code:88130-7097
Practice Address - Country:US
Practice Address - Phone:575-359-4719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4180225100000X
CAPT291278225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist