Provider Demographics
NPI:1053746701
Name:MILLIAM, ROMMEL LIM (RPT)
Entity type:Individual
Prefix:MR
First Name:ROMMEL
Middle Name:LIM
Last Name:MILLIAM
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
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Mailing Address - Street 1:11 MILO DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-2037
Mailing Address - Country:US
Mailing Address - Phone:845-800-8795
Mailing Address - Fax:845-673-5760
Practice Address - Street 1:42 RYKOWSKI LN
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-4018
Practice Address - Country:US
Practice Address - Phone:845-673-5554
Practice Address - Fax:845-673-5760
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY019050-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist