Provider Demographics
NPI:1528693645
Name:ROMEO, ALEXANDRA MARIE
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:MARIE
Last Name:ROMEO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 DANBURY ROAD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4010
Mailing Address - Country:US
Mailing Address - Phone:203-883-0038
Mailing Address - Fax:203-724-4838
Practice Address - Street 1:249 DANBURY ROAD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4010
Practice Address - Country:US
Practice Address - Phone:203-883-0038
Practice Address - Fax:203-724-4838
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431574363L00000X
CT8872363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner