Healthcare Provider Details

I. General information

NPI: 1376732206
Provider Name (Legal Business Name): JUDITH T ROMANO, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 10/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 N 5TH ST SUITE 101
MARTINS FERRY OH
43935-1582
US

IV. Provider business mailing address

222 N 5TH ST SUITE 101
MARTINS FERRY OH
43935-1582
US

V. Phone/Fax

Practice location:
  • Phone: 740-633-6480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35077419R
License Number StateOH

VIII. Authorized Official

Name: PAUL A ROMANO
Title or Position: BUSINESS MANAGER
Credential:
Phone: 740-633-6486