MEDICARE: ELINA ROMANYCHEVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1104537737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELINA ROMANYCHEVA

Provider Business Mailing Address
First Line	:	1511 FENTON DR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3555
Country	:	US
Telephone Number	:	718-290-7370
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 FENTON DR
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33445-3555
Country	:	US
Telephone Number	:	718-290-7370
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	12/05/2022

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