Provider Demographics
NPI:1720027691
Name:ROMERO, LUZ YDANIA (MD)
Entity Type:Individual
Prefix:DR
First Name:LUZ
Middle Name:YDANIA
Last Name:ROMERO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1255 ROUTE 70
Mailing Address - Street 2:STE. 22 S
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5900
Mailing Address - Country:US
Mailing Address - Phone:732-364-0041
Mailing Address - Fax:732-364-5578
Practice Address - Street 1:1255 ROUTE 70
Practice Address - Street 2:STE. 22 S
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-364-0041
Practice Address - Fax:732-364-5578
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA 68618174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist