Provider Demographics
NPI:1104182997
Name:ROMAN, CYNTHIA (MA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:ROMAN
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607071
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-7071
Mailing Address - Country:US
Mailing Address - Phone:787-220-2002
Mailing Address - Fax:
Practice Address - Street 1:84-11 CALLE 70
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961-4541
Practice Address - Country:US
Practice Address - Phone:787-220-2002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-05
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR3668103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist