Provider Demographics
NPI:1962795864
Name:CACES, PHYLLIS ADRIENNE ROMERO (MD)
Entity type:Individual
Prefix:DR
First Name:PHYLLIS ADRIENNE
Middle Name:ROMERO
Last Name:CACES
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 1:20 WATERSIDE PLZ 14D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2613
Mailing Address - Country:US
Mailing Address - Phone:201-400-3171
Mailing Address - Fax:
Practice Address - Street 1:1 ADRIAN WAY
Practice Address - Street 2:
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-1452
Practice Address - Country:US
Practice Address - Phone:201-262-1867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY274478207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine