Provider Demographics
NPI:1205128238
Name:ROME MEDICAL PRACTICE
Entity type:Organization
Organization Name:ROME MEDICAL PRACTICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WALEED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-338-7232
Mailing Address - Street 1:1617 N JAMES ST
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-2852
Mailing Address - Country:US
Mailing Address - Phone:315-337-0202
Mailing Address - Fax:315-337-8188
Practice Address - Street 1:1617 N JAMES ST
Practice Address - Street 2:SUITE 700
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-2852
Practice Address - Country:US
Practice Address - Phone:315-337-0202
Practice Address - Fax:315-337-8188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty