1912992991 NPI number — NICHOLAS M ROMANSKY DPM

Table of content: NICHOLAS M ROMANSKY DPM (NPI 1912992991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912992991 NPI number — NICHOLAS M ROMANSKY DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMANSKY
Provider First Name:
NICHOLAS
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

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:
1912992991
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/12/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 N MONROE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEDIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19063-3037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-565-3668
Provider Business Mailing Address Fax Number:
610-565-9722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 N MONROE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063-3037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-565-3668
Provider Business Practice Location Address Fax Number:
610-565-9722
Provider Enumeration Date:
09/15/2005

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: 213ES0103X , with the licence number:  SC003145L , 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)

  • Identifier: 0097358000 . This is a "KEYSTONE HEALTH PLAN EAST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01101572-01 . This is a "AMERICHOICE-PHOENIXVILLE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7071841 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: D00503 . This is a "AHA (AMERIHEALTH ADMINIST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000786653 . This is a "GREAT WEST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01101572-02 . This is a "AMERICHOICE MEDIA OFFICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 265239 . This is a "MAMSI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 480012888 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 362910 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0097358000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 400503 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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