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General NPI Number Information
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NPI Number | 1366611998
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Entity Type | Organization
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Legal Business Name | MARC J ROMANO, PSY.D., INC.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 1881 NE 26TH ST
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City | WILTON MANORS
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State | FL
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Zip | 33305-1416
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Country | US
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Telephone | 954-296-9464
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Fax | 954-567-1436
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Provider Business Mailing Address
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Address Line | PO BOX 70516
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City | FORT LAUDERDALE
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State | FL
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Zip | 33307-0516
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Country | US
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Telephone | 954-296-9464
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Fax | 954-567-1436
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. MARC JOSEPH ROMANO
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Credential | PSY.D.
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Telephone | 954-296-9464
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 5846
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License Number State | FL
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