Provider Demographics
NPI:1912277484
Name:ROMA PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:ROMA PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELZBIETA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MS
Authorized Official - Phone:917-291-7917
Mailing Address - Street 1:1820 E 13TH ST APT 5L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2823
Mailing Address - Country:US
Mailing Address - Phone:917-201-7917
Mailing Address - Fax:347-374-5973
Practice Address - Street 1:1820 E 13TH ST APT 5L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2823
Practice Address - Country:US
Practice Address - Phone:917-201-7917
Practice Address - Fax:347-374-5973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-30
Last Update Date:2011-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024429-1252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency