Provider Demographics
NPI:1962600445
Name:ROMEO, CATHY C (NP,PHD)
Entity type:Individual
Prefix:DR
First Name:CATHY
Middle Name:C
Last Name:ROMEO
Suffix:
Gender:F
Credentials:NP,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 SANTIAGO RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-3957
Mailing Address - Country:US
Mailing Address - Phone:410-997-5333
Mailing Address - Fax:410-992-9819
Practice Address - Street 1:9650 SANTIAGO RD
Practice Address - Street 2:SUITE 108
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-3957
Practice Address - Country:US
Practice Address - Phone:410-997-5333
Practice Address - Fax:410-992-9819
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDRO79304363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS70370Medicare UPIN