Provider Demographics
NPI:1306570163
Name:ROMAN, DAMIAN (CRNP)
Entity type:Individual
Prefix:
First Name:DAMIAN
Middle Name:
Last Name:ROMAN
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 39TH ST # C424
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-3237
Mailing Address - Country:US
Mailing Address - Phone:206-713-6919
Mailing Address - Fax:
Practice Address - Street 1:147 39TH ST APT 424
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15201-3304
Practice Address - Country:US
Practice Address - Phone:206-713-6919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN749927163WG0000X
PASP027055363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice