Healthcare Provider Details

I. General information

NPI: 1558743187
Provider Name (Legal Business Name): JASON T. ROMANCIK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2015
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 2ND ST
HACKENSACK NJ
07601-2191
US

IV. Provider business mailing address

92 2ND ST
HACKENSACK NJ
07601-2191
US

V. Phone/Fax

Practice location:
  • Phone: 551-996-5900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA12507100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: