Provider Demographics
NPI:1851438550
Name:VROMAN, CRAIG RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:RICHARD
Last Name:VROMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CRAIG
Other - Middle Name:
Other - Last Name:VROMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:8801 HORIZON BLVD NE
Mailing Address - Street 2:SUITE 360
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87113-1533
Mailing Address - Country:US
Mailing Address - Phone:505-246-2622
Mailing Address - Fax:505-213-0103
Practice Address - Street 1:5757 HARPER DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-3566
Practice Address - Country:US
Practice Address - Phone:505-888-5757
Practice Address - Fax:505-875-0160
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432251207W00000X
NJ25MA08284500207W00000X
NMMD2009-0475207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMP00752741OtherRAILROAD CARRIER (RRB)
PA1019622510002Medicaid
NJ3498506Medicaid
NJ114255QC2Medicare PIN
PA116292F0HMedicare PIN
PA1019622510002Medicaid