Provider Demographics
NPI:1336284751
Name:ROMANIA, KATHLEEN M (OT05231966)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:M
Last Name:ROMANIA
Suffix:
Gender:F
Credentials:OT05231966
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 RESEARCH PKWY
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-1929
Mailing Address - Country:US
Mailing Address - Phone:203-294-1998
Mailing Address - Fax:203-294-1189
Practice Address - Street 1:8 RESEARCH PKWY
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-1929
Practice Address - Country:US
Practice Address - Phone:203-294-1998
Practice Address - Fax:203-294-1189
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT819225X00000X, 225XE1200X, 225XH1200X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Not Answered225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
Not Answered225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Not Answered225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00415176800OtherBLUE CARE FAMILY PLAN
CT183158OtherFIRST CHOICE
CT6404254OtherUNITED HEALTHCARE
CT0V1691OtherHEALTHNET
DE39111777OtherAETNA
CT00415176800Medicaid
CT712712OtherCONNECTICARE
CTA667399OtherOXFORD
CT130000819CT04OtherANTHEM BCBS
CT00415176800Medicaid