Provider Demographics
NPI:1083846752
Name:ROMAN, DIGNA DIANETTE (MD)
Entity Type:Individual
Prefix:
First Name:DIGNA
Middle Name:DIANETTE
Last Name:ROMAN
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:PO BOX 977
Mailing Address - Street 2:ROAD 2 YEGUADA INTERIOR KM 93 H 2
Mailing Address - City:CAMUY
Mailing Address - State:PR
Mailing Address - Zip Code:00627-0977
Mailing Address - Country:US
Mailing Address - Phone:787-391-4945
Mailing Address - Fax:
Practice Address - Street 1:ROAD 2 YEGUADA INTERIOR ARIAS' SECTOR, KM 93 H 2
Practice Address - Street 2:
Practice Address - City:CAMUY
Practice Address - State:PR
Practice Address - Zip Code:00627
Practice Address - Country:US
Practice Address - Phone:787-391-4945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-14
Last Update Date:2009-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17671208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice