Provider Demographics
NPI:1912796731
Name:ROMAN, CARLY L (CPD)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:L
Last Name:ROMAN
Suffix:
Gender:
Credentials:CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8112 SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-8714
Mailing Address - Country:US
Mailing Address - Phone:724-685-1093
Mailing Address - Fax:
Practice Address - Street 1:8112 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:MASURY
Practice Address - State:OH
Practice Address - Zip Code:44438-8714
Practice Address - Country:US
Practice Address - Phone:724-685-1093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty