Healthcare Provider Details

I. General information

NPI: 1992731475
Provider Name (Legal Business Name): DEAN D ROMANICK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 LAKEVILLE RD
GENESEO NY
14454-9762
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 278980
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-243-1400
  • Fax: 585-243-0218
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number213203
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: