Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ROMEO GONZAGA ICASIANO, MD
ActivePediatrics · MONTROSE, CO
Registration Details
- NPI Number
- 1114928066
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 2, 2005 (20.780276614967 yrs)
- Last Updated
- Apr 10, 2012
- License
-
37326 (CO)
Practice Information
- Address
-
947 SO 5TH STMONTROSE, CO, 814015716Browse CO providers · Browse ZIP 81401
- Phone
- 8702492421
- Fax
- 9702498897
- Primary Specialty
-
Pediatrics
208000000X
Other Pediatrics Providers in MONTROSE, CO
| Name | Credential | NPI |
|---|---|---|
| THOMAS DAWSON WIARD | MD | 1760483622 |
| MARY LOUISE VADER | DO | 1568454106 |
| LIBUSE K ENGELBACH | MD | 1316960651 |
| GREGORY PAUL SUCHON | MD | 1407064124 |
| THOMAS C MILLER | M.D. | 1275738619 |
| DR. LISA CAROL BAKER | M.D. | 1700045192 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.