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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386668499 | NPPES |
| New York | MEDICAID | 01453130 |
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