Provider Demographics
NPI:1083600621
Name:ROMANO, CHARLES F (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:ROMANO
Suffix:
Gender:M
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:PO BOX 2002
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-4502
Mailing Address - Country:US
Mailing Address - Phone:315-449-2208
Mailing Address - Fax:315-445-2936
Practice Address - Street 1:531 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4084
Practice Address - Country:US
Practice Address - Phone:315-788-7990
Practice Address - Fax:315-788-4248
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY170369207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C33028Medicare UPIN