1710985627 NPI number — MRS. ADELE EDITH ROMAN

Table of content: MRS. ADELE EDITH ROMAN (NPI 1710985627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710985627 NPI number — MRS. ADELE EDITH ROMAN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMAN
Provider First Name:
ADELE
Provider Middle Name:
EDITH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOLDBERG
Provider Other First Name:
ADELE
Provider Other Middle Name:
EDITH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPH
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1710985627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1150 BOWER HILL RD
Provider Second Line Business Mailing Address:
APT. 902 B
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15243-1349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-429-5138
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1045 BOWER HILL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15243-1842
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-942-4900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  RP023507L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)