Provider Demographics
NPI:1841410008
Name:ORQUE, ROMULA A (MD)
Entity Type:Individual
Prefix:MRS
First Name:ROMULA
Middle Name:A
Last Name:ORQUE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:ROMULA
Other - Middle Name:ROQUE
Other - Last Name:TATLONGHARI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:632 PALMER RD
Mailing Address - Street 2:APT 5K
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-5133
Mailing Address - Country:US
Mailing Address - Phone:914-337-1441
Mailing Address - Fax:914-336-0603
Practice Address - Street 1:40 WILSON PARK DRIVE
Practice Address - Street 2:IHAD
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-1096
Practice Address - Country:US
Practice Address - Phone:914-468-0358
Practice Address - Fax:914-336-0603
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115303207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B16948Medicare UPIN
58461Medicare ID - Type Unspecified