1720198831 NPI number — DAVID F ROMANO DMD PA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720198831 NPI number — DAVID F ROMANO DMD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID F ROMANO DMD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720198831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
49 RIDGEDALE AVE
Provider Second Line Business Mailing Address:
STE 202
Provider Business Mailing Address City Name:
EAST HANOVER
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-884-1144
Provider Business Mailing Address Fax Number:
973-884-3144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
49 RIDGEDALE AVE
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
EAST HANOVER
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-884-1144
Provider Business Practice Location Address Fax Number:
973-884-3144
Provider Enumeration Date:
08/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROMANO
Authorized Official First Name:
LAURA
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OFFICE MANAGER CORPORATION SECRETAR
Authorized Official Telephone Number:
973-884-1144

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  9017 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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