Healthcare Provider Details

I. General information

NPI: 1063463107
Provider Name (Legal Business Name): SARAH E ROME DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 11/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 US HWY RTE 206
MONTAGUE NJ
07827
US

IV. Provider business mailing address

4175 VETERANS MEMORIAL HWY SUITE 202
RONKONKOMA NY
11779-7639
US

V. Phone/Fax

Practice location:
  • Phone: 973-293-0010
  • Fax: 973-293-0018
Mailing address:
  • Phone: 631-580-5200
  • Fax: 631-580-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberNJ QA01026600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: