Provider Demographics
NPI:1992960587
Name:ROMAN, ALEXANDER JUDE (PT)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:JUDE
Last Name:ROMAN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1305 MEADSTON DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-9725
Mailing Address - Country:US
Mailing Address - Phone:919-423-3898
Mailing Address - Fax:
Practice Address - Street 1:104 S ESTES DR # 140
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2866
Practice Address - Country:US
Practice Address - Phone:919-933-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC348171100000X
NC10210225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No171100000XOther Service ProvidersAcupuncturist