Provider Demographics
NPI:1386463081
Name:ROMANO, ASHLEY T (CPRS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:T
Last Name:ROMANO
Suffix:
Gender:F
Credentials:CPRS
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:T
Other - Last Name:CONKLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPRS
Mailing Address - Street 1:61 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2072
Mailing Address - Country:US
Mailing Address - Phone:862-668-2943
Mailing Address - Fax:
Practice Address - Street 1:175 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1004
Practice Address - Country:US
Practice Address - Phone:973-383-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCPRS-50341175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist