Healthcare Provider Details

I. General information

NPI: 1497474381
Provider Name (Legal Business Name): SUSAN KENT ROMANN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2022
Last Update Date: 08/24/2022
Certification Date: 08/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 SPRUCE ST STE 304
PHILADELPHIA PA
19106-4023
US

IV. Provider business mailing address

149 CRAFTON AVE
PITMAN NJ
08071-1546
US

V. Phone/Fax

Practice location:
  • Phone: 215-829-3521
  • Fax:
Mailing address:
  • Phone: 215-767-9662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberRP443341
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: