Provider Demographics
NPI:1255486353
Name:ROMANO, AUGUSTINE CARMINE (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTINE
Middle Name:CARMINE
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 1:170 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:ROCKY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11788
Mailing Address - Country:US
Mailing Address - Phone:631-331-4377
Mailing Address - Fax:631-331-4459
Practice Address - Street 1:170 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:ROCKY POINT
Practice Address - State:NY
Practice Address - Zip Code:11788
Practice Address - Country:US
Practice Address - Phone:631-331-4377
Practice Address - Fax:631-331-4459
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2090842084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
92Z071Medicare ID - Type Unspecified
92Z071Medicare ID - Type Unspecified