Provider Demographics
NPI:1922110493
Name:ROMERO FAMILY PRACTICE
Entity Type:Organization
Organization Name:ROMERO FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALELI
Authorized Official - Middle Name:GELLOR
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-420-3521
Mailing Address - Street 1:6009 PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23464-3808
Mailing Address - Country:US
Mailing Address - Phone:757-420-9251
Mailing Address - Fax:757-424-5217
Practice Address - Street 1:6009 PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23464-3808
Practice Address - Country:US
Practice Address - Phone:757-420-9251
Practice Address - Fax:757-424-5217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA00X649R01OtherCYNTHIA INDIVIDUAL PTAN NUMBER
1922110493OtherGROUP NPI
1376659300OtherCYNTHIA INDIVDUAL NPI#
VA00X649R02OtherALELI INDIVIDUAL PTAN
1750497780OtherALELI ROMERO IND NPI
VA00X649R01OtherCYNTHIA INDIVIDUAL PTAN NUMBER