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NPI Code Detail

MEDICARE: ODALYS MARIE ROMAN

MEDICARE: ODALYS MARIE ROMAN
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
1101Y00000XCounselor

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5Y10086OTHERMAMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
112529OTHERMAHNE
2042622756OTHERMACCA
31134107113OTHERMANHP
4997303OTHERMANETWORK HEALTH
61134107113OTHERMAFALLON
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
871756OTHERMATUFTS
91134107113OTHERMAMBHP
101134107113OTHERMABEACON

General Provider Information

NPI Number : 1609370550
Entity Type Code : Individual
Provider Name (Legal Business Name) : ODALYS MARIE ROMAN
Provider Business Mailing Address
First Line : 80 COMMERCIAL ST
Second Line :
City : HOLYOKE
State : MA
Zip : 01040-4704
Country : US
Telephone Number : 413-846-0445
Fax Number :
Provider Business Practice Location Address
First Line : 80 COMMERCIAL ST
Second Line :
City : HOLYOKE
State : MA
Zip : 01040-4704
Country : US
Telephone Number : 413-846-0445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2018
Last Update Date : 03/23/2018

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Directions to “ ODALYS MARIE ROMAN ” Practice Location

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