San Roman, Guillermo A.

San Roman, Guillermo A. is an individual health care provider with primary practice located at 1630 Deer Park Ave , Deer Park NY 11729-5210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. San Roman, Guillermo A. can be contacted via phone (631) 242-6166.

Contact Information

Primary practice address
1630 Deer Park Ave Deer Park NY 11729-5210
Phone: (631) 242-6166
Fax: (631) 242-8768
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 150903 New York

Profile Details

NPI number 1386668499
LBN Legal business name San Roman, Guillermo A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jan 20th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386668499 NPPES
New York MEDICAID 01453130

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