MEDICARE: ROMAXTER LLC

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1801314984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROMAXTER LLC

Provider Business Mailing Address
First Line	:	PO BOX 638
Second Line	:
City	:	SAINT JAMES
State	:	NY
Zip	:	11780-0638
Country	:	US
Telephone Number	:	516-408-0333
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 LAKE AVE
Second Line	:
City	:	SAINT JAMES
State	:	NY
Zip	:	11780-5048
Country	:	US
Telephone Number	:	516-408-0333
Fax Number	:

Authorized Official
Title or Position	:	VICE-PRESIDENT WELL-CHOICES
Name	:	GEORGE F BLESSING
Credential	:
Telephone Number	:	516-462-2040

Provider Enumeration Date	:	09/08/2017
Last Update Date	:	07/21/2022

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