Provider Demographics
NPI:1194179002
Name:ROMULUS, PAULA
Entity Type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:
Last Name:ROMULUS
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 1:1085 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3111
Mailing Address - Country:US
Mailing Address - Phone:516-589-6019
Mailing Address - Fax:
Practice Address - Street 1:20 JERUSALEM AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-4980
Practice Address - Country:US
Practice Address - Phone:516-302-2060
Practice Address - Fax:516-358-2828
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-17
Last Update Date:2016-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343028591010R163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse