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NPI Code Detail

MEDICARE: MS. JUNE MARY ROMAN MSN, RN, PMHCNS-BC

MEDICARE: MS. JUNE MARY ROMAN MSN, RN, PMHCNS-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0809XAdult Psychiatric/Mental Health Registered NurseRN172769LPA

General Provider Information

NPI Number : 1083812044
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUNE MARY ROMAN MSN, RN, PMHCNS-BC
Provider Business Mailing Address
First Line : 272 SHADELAND AVE
Second Line :
City : DREXEL HILL
State : PA
Zip : 19026-2120
Country : US
Telephone Number : 610-622-4045
Fax Number :
Provider Business Practice Location Address
First Line : 4508 CHESTNUT ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19139-3608
Country : US
Telephone Number : 267-787-8245
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2007
Last Update Date : 01/11/2022

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