Individual
ROY GERONIMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
175 FORE RIVER PKWY, PORTLAND, ME 04102-2779
(207) 879-3000
Mailing address
66 FARWELL ST, LEWISTON, ME 04240-4803
(808) 987-8548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN65387
ME
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP241775
ME
Other
Enumeration date
05/29/2025
Last updated
07/22/2025
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