Provider Demographics
NPI:1922049089
Name:ROMEO, LOUIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:C
Last Name:ROMEO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:185 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:RIVERHEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11901-2121
Mailing Address - Country:US
Mailing Address - Phone:631-298-4479
Mailing Address - Fax:631-591-3047
Practice Address - Street 1:64 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:RIVERHEAD
Practice Address - State:NY
Practice Address - Zip Code:11901-4455
Practice Address - Country:US
Practice Address - Phone:631-369-5000
Practice Address - Fax:631-574-8773
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189682207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY73G011OtherEMPIRE BC.BS
NY5839496OtherAETNA
NY73G011Medicare ID - Type Unspecified
NY01716783Medicaid
NYG41424Medicare UPIN