Provider Demographics
NPI:1154865202
Name:ROMANZI, TREVOR
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:ROMANZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 STANTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-1623
Mailing Address - Country:US
Mailing Address - Phone:212-473-8152
Mailing Address - Fax:212-475-7588
Practice Address - Street 1:145 STANTON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-1623
Practice Address - Country:US
Practice Address - Phone:212-473-8152
Practice Address - Fax:212-475-7588
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0267801235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist