Provider Demographics
NPI:1588783211
Name:ROMANO, NOREEN NINFA (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:NOREEN
Middle Name:NINFA
Last Name:ROMANO
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 PINE ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1619
Mailing Address - Country:US
Mailing Address - Phone:201-251-9305
Mailing Address - Fax:
Practice Address - Street 1:115 PINE ST
Practice Address - Street 2:SUITE 207
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1619
Practice Address - Country:US
Practice Address - Phone:201-251-9305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2012-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3311103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ075984Medicare ID - Type UnspecifiedPSYCHOLOGIST