Provider Demographics
NPI:1417163254
Name:DR D GINO ROMIG PC
Entity Type:Organization
Organization Name:DR D GINO ROMIG PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D
Authorized Official - Middle Name:GINO
Authorized Official - Last Name:ROMIG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:610-433-3990
Mailing Address - Street 1:1202 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102
Mailing Address - Country:US
Mailing Address - Phone:610-433-3990
Mailing Address - Fax:610-433-3990
Practice Address - Street 1:1202 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18102
Practice Address - Country:US
Practice Address - Phone:610-433-3990
Practice Address - Fax:610-433-3990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE004629T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00548478Medicaid
PA00548478Medicaid
PAR0288861Medicare ID - Type Unspecified