Provider Demographics
NPI:1356417893
Name:ROMERO, PHILLIP E (MD)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:E
Last Name:ROMERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:115 E 57TH ST STE 640
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2392
Mailing Address - Country:US
Mailing Address - Phone:212-477-9886
Mailing Address - Fax:646-612-7947
Practice Address - Street 1:745 5TH AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10151-0099
Practice Address - Country:US
Practice Address - Phone:212-477-9886
Practice Address - Fax:646-612-7947
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2017-05-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1370422084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY97A061OtherMEDICARE PTAN