Provider Demographics
NPI:1962847392
Name:ROMANO, MARIA FILOMENA (MS, PD SDA)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:FILOMENA
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MS, PD SDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LYMAN PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-3224
Mailing Address - Country:US
Mailing Address - Phone:917-562-0384
Mailing Address - Fax:
Practice Address - Street 1:83 MARLBOROUGH RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-4301
Practice Address - Country:US
Practice Address - Phone:718-284-3110
Practice Address - Fax:718-989-9237
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225506031174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist