MEDICARE: AYANA ROMAIN

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
1	225X00000X	Occupational Therapist	14049	CA

General Provider Information

NPI Number	:	1306241732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AYANA ROMAIN

Provider Business Mailing Address
First Line	:	936 E 104TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	936 E 104TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-2816
Country	:	US
Telephone Number	:	800-330-7711
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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Directions to “ AYANA ROMAIN ” Practice Location

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