Provider Demographics
NPI:1194880047
Name:ROMANO, DAVID JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSEPH
Last Name:ROMANO
Suffix:
Gender:M
Credentials:DPM
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 166
Mailing Address - Street 2:
Mailing Address - City:GLEN DALE
Mailing Address - State:WV
Mailing Address - Zip Code:26038-0166
Mailing Address - Country:US
Mailing Address - Phone:304-843-5066
Mailing Address - Fax:304-843-5067
Practice Address - Street 1:400 3RD ST
Practice Address - Street 2:
Practice Address - City:GLEN DALE
Practice Address - State:WV
Practice Address - Zip Code:26038-1416
Practice Address - Country:US
Practice Address - Phone:304-843-5066
Practice Address - Fax:304-843-5067
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV10417213ES0131X
NYN005997213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYPJ3831Medicare ID - Type Unspecified
NYV00341Medicare UPIN