Provider Demographics
NPI:1386910602
Name:ROMAIN, SANDIE (ANP)
Entity type:Individual
Prefix:MRS
First Name:SANDIE
Middle Name:
Last Name:ROMAIN
Suffix:
Gender:F
Credentials:ANP
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 1030
Mailing Address - Street 2:ONE GUSTAVE L. LEVY PLACE
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-0310
Mailing Address - Country:US
Mailing Address - Phone:212-241-5881
Mailing Address - Fax:212-241-0065
Practice Address - Street 1:ONE GUSTAVE L. LEVY PLACE
Practice Address - Street 2:BOX 1030
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-5881
Practice Address - Fax:212-241-0065
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305802363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health