Healthcare Provider Details

I. General information

NPI: 1689003782
Provider Name (Legal Business Name): JOSE F ROMNEY RN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2013
Last Update Date: 11/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 HUDSON PL 1A
STATEN ISLAND NY
10303-2626
US

IV. Provider business mailing address

49 HUDSON PL 1A
STATEN ISLAND NY
10303-2626
US

V. Phone/Fax

Practice location:
  • Phone: 877-686-0868
  • Fax: 206-888-2075
Mailing address:
  • Phone: 877-686-0868
  • Fax: 206-888-2075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number315459
License Number StateNY

VIII. Authorized Official

Name: MR. JOSE FERNANDES ROMNEY
Title or Position: OWNER
Credential: RN
Phone: 877-686-0868