Provider Demographics
NPI:1043558711
Name:ROMBA, REBECCA
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:ROMBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 W 23RD ST
Mailing Address - Street 2:SUITE #8, EBCO PARK
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2915
Mailing Address - Country:US
Mailing Address - Phone:716-838-6060
Mailing Address - Fax:
Practice Address - Street 1:2820 W 23RD ST
Practice Address - Street 2:SUITE #8, EBCO PARK
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2915
Practice Address - Country:US
Practice Address - Phone:716-838-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261618163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse