Provider Demographics
NPI:1104537737
Name:ROMANYCHEVA, ELINA
Entity type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:ROMANYCHEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 FENTON DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-3555
Mailing Address - Country:US
Mailing Address - Phone:718-290-7370
Mailing Address - Fax:
Practice Address - Street 1:1511 FENTON DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-3555
Practice Address - Country:US
Practice Address - Phone:718-290-7370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool