Healthcare Provider Details

I. General information

NPI: 1992080352
Provider Name (Legal Business Name): JAMES N ROMANELLI MD P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2011
Last Update Date: 06/23/2022
Certification Date: 06/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 BROADHOLLOW RD STE 100
MELVILLE NY
11747-3671
US

IV. Provider business mailing address

510 BROADHOLLOW ROAD SUITE 100
MELVILLE NY
11747
US

V. Phone/Fax

Practice location:
  • Phone: 631-424-3600
  • Fax:
Mailing address:
  • Phone: 631-424-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHARINE PYNE
Title or Position: ADMINISTRATOR
Credential:
Phone: 631-424-3600