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General NPI Number Information
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NPI Number | 1184640708
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Entity Type | Organization
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Legal Business Name | ROME MEDICAL PRACTICE PC
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 04/26/2021
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Provider Practice Location Address
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Address Line | 267 AVERY LANE, SUITE 300
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City | ROME
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State | NY
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Zip | 13441
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Country | US
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Telephone | 315-338-7636
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Fax | 315-356-4982
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Provider Business Mailing Address
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Address Line | 267 AVERY LANE, SUITE 300
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City | ROME
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State | NY
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Zip | 13441
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Country | US
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Telephone | 315-338-7636
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Fax | 315-356-4982
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | LISA TAURISANO
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Credential |
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Telephone | 315-338-7636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 1990091
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License Number State | NY
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