Provider Demographics
NPI:1134190499
Name:ROMEO, ANA (DO)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:
Last Name:ROMEO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0019
Mailing Address - Country:US
Mailing Address - Phone:718-762-8080
Mailing Address - Fax:718-762-2079
Practice Address - Street 1:3726 76TH ST FL 1
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6508
Practice Address - Country:US
Practice Address - Phone:718-762-8080
Practice Address - Fax:718-762-2079
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191443207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01565044Medicaid
NY01750Medicare PIN
NY01565044Medicaid