Provider Demographics
NPI:1194966796
Name:ROMANO, DAVID ROCCO (PT)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROCCO
Last Name:ROMANO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8942 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3902
Mailing Address - Country:US
Mailing Address - Phone:718-541-9146
Mailing Address - Fax:347-374-5244
Practice Address - Street 1:8942 15TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228-3902
Practice Address - Country:US
Practice Address - Phone:718-541-9146
Practice Address - Fax:347-374-5244
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024602225100000X
NY0299027652255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer