Healthcare Provider Details

I. General information

NPI: 1538632773
Provider Name (Legal Business Name): GREGORY ROMANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2019
Last Update Date: 01/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

IV. Provider business mailing address

9100 BABCOCK BLVD
PITTSBURGH PA
15237-5815
US

V. Phone/Fax

Practice location:
  • Phone: 412-748-5589
  • Fax: 412-630-7610
Mailing address:
  • Phone: 412-748-5589
  • Fax: 412-630-7610

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN636970
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: