Provider Demographics
NPI:1417062332
Name:ROMANO, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
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 1:43 KNAPP ROAD
Mailing Address - Street 2:
Mailing Address - City:POUNO RIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:10576
Mailing Address - Country:US
Mailing Address - Phone:516-987-7540
Mailing Address - Fax:212-645-3541
Practice Address - Street 1:43 KNAPP ROAD
Practice Address - Street 2:
Practice Address - City:POUNO RIDGE
Practice Address - State:NY
Practice Address - Zip Code:10576
Practice Address - Country:US
Practice Address - Phone:516-987-7540
Practice Address - Fax:212-645-3541
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120747207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NS1392OtherOXFORD
354041Medicare ID - Type Unspecified
C09059Medicare UPIN