Provider Demographics
NPI:1043406762
Name:ROMANOW, JENNIFER MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MARIE
Last Name:ROMANOW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 N FILLMORE ST
Mailing Address - Street 2:#321
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-6701
Mailing Address - Country:US
Mailing Address - Phone:703-888-6135
Mailing Address - Fax:
Practice Address - Street 1:3990 FETTLER PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22025-1997
Practice Address - Country:US
Practice Address - Phone:888-381-4858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine