Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 027010 | NY |
N | 207KA0200X | Allergist | PENDING | NY |
N | 207R00000X | Internist | 027010 | NY |
N | 111NI0900X | Internist | 027010 | NY |
N | 207R00000X | Internist | PENDING | NY |
N | 111NI0900X | Internist | PENDING | NY |
NPI | 1275208183 |
---|---|
Provider Name | Juan Abel Romero Loor SR. |
First Address | Elmhurst, NY 11373-5156 |
Second Address | Elmhurst, NY 11373-5156 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2021 |
Last Update Date | 12/08/2021 |