Provider Demographics
NPI:1063561538
Name:LEMEGA, ROMAN W (PHD)
Entity type:Individual
Prefix:DR
First Name:ROMAN
Middle Name:W
Last Name:LEMEGA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MIDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-1810
Mailing Address - Country:US
Mailing Address - Phone:973-377-2213
Mailing Address - Fax:
Practice Address - Street 1:248 COLUMBIA TPKE
Practice Address - Street 2:BUILDING # 3
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-1210
Practice Address - Country:US
Practice Address - Phone:973-377-2213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2369103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist