Provider Demographics
NPI:1952423097
Name:CARLOS A. ROMERO, MD,PC
Entity type:Organization
Organization Name:CARLOS A. ROMERO, MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-741-6464
Mailing Address - Street 1:173 MINEOLA BLVD
Mailing Address - Street 2:
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-2528
Mailing Address - Country:US
Mailing Address - Phone:516-741-6464
Mailing Address - Fax:516-877-2440
Practice Address - Street 1:173 MINEOLA BLVD
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2528
Practice Address - Country:US
Practice Address - Phone:516-741-6464
Practice Address - Fax:516-877-2440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118857208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYCO8428Medicare UPIN