Provider Demographics
NPI:1215278692
Name:VERALLO-ROWELL, VERMEN M (MD)
Entity type:Individual
Prefix:DR
First Name:VERMEN
Middle Name:M
Last Name:VERALLO-ROWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04046-5405
Mailing Address - Country:US
Mailing Address - Phone:917-916-6722
Mailing Address - Fax:646-395-1568
Practice Address - Street 1:321 KINGS HWY
Practice Address - Street 2:
Practice Address - City:KENNEBUNKPORT
Practice Address - State:ME
Practice Address - Zip Code:04046-5405
Practice Address - Country:US
Practice Address - Phone:917-916-6722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME012609174400000X
NY268580174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist