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General NPI Number Information
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NPI Number | 1427136993
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Entity Type | Individual
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Provider Name | BRUCE J ROMANCZUK MD
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Gender | Male
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1145 BEACON AVENUE
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2626
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Country | US
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Telephone | 609-597-7110
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Fax | 609-597-7113
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Provider Business Mailing Address
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Address Line | 1145 BEACON AVENUE
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City | MANAHAWKIN
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State | NJ
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Zip | 08050-2626
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Country | US
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Telephone | 609-597-7110
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Fax | 609-597-7113
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 25MA03704500
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | MD017065E
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License Number State | PA
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