1588958573 NPI number — STEPHANIE KAY ROMITO MSC

Table of content: STEPHANIE KAY ROMITO MSC (NPI 1588958573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588958573 NPI number — STEPHANIE KAY ROMITO MSC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMITO
Provider First Name:
STEPHANIE
Provider Middle Name:
KAY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSC
Provider Gender Code:
F

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:
1588958573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18611 VINEYARD POINT LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORNELIUS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28031-7991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-562-3174
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
845 CHURCH STREET NORTH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28025-4375
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-262-1320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/07/2011

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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