Provider Demographics
NPI:1215990403
Name:ROMANO, DAVID L (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:ROMANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1030 SAINT GEORGES AVE
Mailing Address - Street 2:STE 201
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1390
Mailing Address - Country:US
Mailing Address - Phone:732-602-0244
Mailing Address - Fax:732-602-2577
Practice Address - Street 1:1030 SAINT GEORGES AVE
Practice Address - Street 2:STE 201
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1390
Practice Address - Country:US
Practice Address - Phone:732-602-0244
Practice Address - Fax:732-602-2577
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA43319207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
E87154Medicare UPIN
538109Medicare ID - Type Unspecified