Provider Demographics
NPI:1033153689
Name:ROMANO, ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:ROMANO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 NAUTILUS DR
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2448
Mailing Address - Country:US
Mailing Address - Phone:609-549-6787
Mailing Address - Fax:609-756-0870
Practice Address - Street 1:41 NAUTILUS DR
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2448
Practice Address - Country:US
Practice Address - Phone:609-549-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB078548208M00000X
NJ25MB07854800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0094897Medicaid
NJPTAN P00738361OtherRAILROAD MEDICARE
NJ098264SDTMedicare PIN
NJI49401Medicare UPIN
NJ0094897Medicaid
NJP00297586RRMedicare Oscar/Certification