MEDICARE: MRS. LORI ANN ROMANO-COLLINS PA-C

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	363AM0700X	Medical Physician Assistant	COOO1963	MD

General Provider Information

NPI Number	:	1316955453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI ANN ROMANO-COLLINS PA-C

Provider Business Mailing Address
First Line	:	8219 TREEBROOKE LN
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1746
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8219 TREEBROOKE LN
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22308-1746
Country	:	US
Telephone Number	:	703-721-0507
Fax Number	:

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

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	10/19/2007

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