MEDICARE: DR. LOURDES ROMANO-JANA M.D.

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	207RR0500X	Rheumatology Physician	MD026989-E	PA

General Provider Information

NPI Number	:	1215050216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOURDES ROMANO-JANA M.D.

Provider Business Mailing Address
First Line	:	4607 HIGHVIEW BLVD
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16509-2220
Country	:	US
Telephone Number	:	814-456-6258
Fax Number	:	814-456-6258

Provider Business Practice Location Address
First Line	:	2931 PEACH ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16508-1842
Country	:	US
Telephone Number	:	814-456-6258
Fax Number	:	814-456-6258

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	07/09/2007

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