Provider Demographics
NPI:1023653094
Name:ROMANELLI IME, LLC
Entity type:Organization
Organization Name:ROMANELLI IME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-652-3528
Mailing Address - Street 1:2001 E LOHMAN AVE STE 110-284
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-3167
Mailing Address - Country:US
Mailing Address - Phone:575-652-3528
Mailing Address - Fax:575-652-3389
Practice Address - Street 1:4500 N SONOMA RANCH BLVD STE 2
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7334
Practice Address - Country:US
Practice Address - Phone:575-652-3528
Practice Address - Fax:572-652-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty