=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265764096
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TAMI LYNN ROMANO PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2010
-----------------------------------------------------
Last Update Date | 06/09/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11602 BEACH CHANNEL DR
-----------------------------------------------------
City | ROCKAWAY PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11694-2073
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-945-7781
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 BEACH 221ST ST
-----------------------------------------------------
City | BREEZY POINT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11697-1524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-474-5553
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 051947
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------