Basic Information
Provider Information
NPI: 1801277132
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROMEO
FirstName: BARRY-STEPHEN
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ROMEO
OtherFirstName: STEPHEN
OtherMiddleName: J
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 2
Mailing Information
Address1: 42 E LAUREL RD STE 2600
Address2:  
City: STRATFORD
State: NJ
PostalCode: 080841354
CountryCode: US
TelephoneNumber: 8565667050
FaxNumber:  
Practice Location
Address1: 42 E LAUREL RD STE 2600
Address2:  
City: STRATFORD
State: NJ
PostalCode: 080841354
CountryCode: US
TelephoneNumber: 8565667050
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/11/2015
LastUpdateDate: 08/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000X83323SCY Allopathic & Osteopathic PhysiciansOtolaryngology 

No ID Information.


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