Provider Demographics
NPI:1144394784
Name:ROMAN, JAIME F (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:F
Last Name:ROMAN
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 1:3751 91ST ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7927
Mailing Address - Country:US
Mailing Address - Phone:718-458-7070
Mailing Address - Fax:718-429-7952
Practice Address - Street 1:3751 91ST ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7927
Practice Address - Country:US
Practice Address - Phone:718-205-5355
Practice Address - Fax:718-429-7952
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY152166207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0064849OtherGHI ID
NY7566OtherAETNA USHC ID
NY10E931OtherEMPIRE MEDICAREID
NY00829790Medicaid
NY10E93OtherEMPIRE BLUE CROSS HMO
NY152166POtherHEALTH CARE PARTNERS ID
NY83578OtherVYTRA ID
NYDP284OtherOXFORD ID
NY100083560101OtherUNITED HEALTH CARE ID
NY10E932OtherEMPIRE BLUE CROSS ID
NY112991572Other1199 HOME CARE ID
NY152166B29OtherHEALTH FIRST ID
NY161395OtherELDERPLAN ID
NM7571OtherAETNA USHC ID
NY297688OtherWELLCARE ID
NY152166C29OtherHEALTH FIRST ID
NY64849Medicare ID - Type UnspecifiedMEDICARE ID