Provider Demographics
NPI:1043799927
Name:ROMANO, CHRISTINA ALYSSE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:ALYSSE
Last Name:ROMANO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:ALYSSE
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:131 S HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:NESCONSET
Mailing Address - State:NY
Mailing Address - Zip Code:11767-1530
Mailing Address - Country:US
Mailing Address - Phone:909-706-5337
Mailing Address - Fax:
Practice Address - Street 1:24 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3487
Practice Address - Country:US
Practice Address - Phone:631-444-6720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
NY022460363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical