Healthcare Provider Details

I. General information

NPI: 1659359669
Provider Name (Legal Business Name): LYNN MARY ROMANO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9111 ANTIQUE ALY UNIT 1
BRIDGEVILLE DE
19933-4682
US

IV. Provider business mailing address

9111 ANTIQUE ALY
BRIDGEVILLE DE
19933-4682
US

V. Phone/Fax

Practice location:
  • Phone: 302-337-9320
  • Fax: 302-337-9640
Mailing address:
  • Phone: 302-337-9320
  • Fax: 302-337-9360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC1-0006165
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number127943
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: