Provider Demographics
NPI:1326121385
Name:GEORGE, ROMANI (MD)
Entity Type:Individual
Prefix:
First Name:ROMANI
Middle Name:
Last Name:GEORGE
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 1:500 W GERMANTOWN PIKE,
Mailing Address - Street 2:CHURCH ON THE MALL, PLYMOUTH MEETING MALL, BOX 80
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462
Mailing Address - Country:US
Mailing Address - Phone:610-291-3391
Mailing Address - Fax:
Practice Address - Street 1:500 W GERMANTOWN PIKE
Practice Address - Street 2:CHURCH ON THE MALL, PLYMOUTH MEETING MALL, BOX 80
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462
Practice Address - Country:US
Practice Address - Phone:610-291-3391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053866L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0001527329Medicaid
PA0001527329Medicaid
PAG09698Medicare UPIN