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General NPI Number Information
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NPI Number | 1992730253
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Entity Type | Organization
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Legal Business Name | MADISON MEDICAL AND SPORTS REHABILITATION L.L.C
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 210 MAIN ST
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City | MADISON
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State | NJ
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Zip | 07940-2209
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Country | US
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Telephone | 973-377-6700
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Fax | 973-377-8008
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Provider Business Mailing Address
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Address Line | 210 MAIN ST
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City | MADISON
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State | NJ
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Zip | 07940-2209
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Country | US
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Telephone | 973-377-6700
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Fax | 973-377-8008
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARMEN ROMANO
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Credential | DC
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Telephone | 973-377-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 38MC00562600
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License Number State | NJ
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