Provider Demographics
NPI:1396047957
Name:ROMERO, PORFINIO JAMES (CNP)
Entity type:Individual
Prefix:MR
First Name:PORFINIO
Middle Name:JAMES
Last Name:ROMERO
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:MR
Other - First Name:P. JAMES
Other - Middle Name:
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CFNP
Mailing Address - Street 1:5310 HOMESTEAD RD NE STE 201
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-1524
Mailing Address - Country:US
Mailing Address - Phone:505-237-2574
Mailing Address - Fax:505-272-2240
Practice Address - Street 1:5310 HOMESTEAD RD NE STE 201
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-237-2574
Practice Address - Fax:505-272-2240
Is Sole Proprietor?:No
Enumeration Date:2010-12-02
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01672363L00000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner