Healthcare Provider Details

I. General information

NPI: 1750348678
Provider Name (Legal Business Name): FRANCIS J. ROMANO P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 POLY PL MEDICAL SERVICE (111)
BROOKLYN NY
11209-7104
US

IV. Provider business mailing address

800 POLY PL
BROOKLYN NY
11209-7104
US

V. Phone/Fax

Practice location:
  • Phone: 718-836-6600
  • Fax: 718-630-3761
Mailing address:
  • Phone: 718-836-6600
  • Fax: 718-630-3761

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number000893
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: