Provider Demographics
NPI:1326074311
Name:ROMANO, GAYLE (NP)
Entity Type:Individual
Prefix:
First Name:GAYLE
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:NP
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 1185
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-7185
Mailing Address - Country:US
Mailing Address - Phone:516-338-5300
Mailing Address - Fax:516-333-1075
Practice Address - Street 1:50 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1348
Practice Address - Country:US
Practice Address - Phone:516-338-5358
Practice Address - Fax:516-333-1075
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF334709363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner