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General NPI Number Information
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NPI Number | 1861156374
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Entity Type | Individual
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Provider Name | CYNTHIA J ROMAN-CHOUINARD PMHNP
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Gender | Female
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Dates
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Enumeration Date | 10/30/2021
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Last Update Date | 10/30/2021
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Provider Practice Location Address
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Address Line | 187 S CANAAN RD
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City | CANAAN
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State | CT
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Zip | 06018-2544
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Country | US
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Telephone | 203-206-7909
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Fax |
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Provider Business Mailing Address
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Address Line | 60 SEMINOLE RD
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City | WATERTOWN
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State | CT
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Zip | 06795-2380
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Country | US
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Telephone |
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Fax |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 10192
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 10192
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License Number State | CT
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