Provider Demographics
NPI:1427602440
Name:ROMAO, LAUREN ALYSSA
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALYSSA
Last Name:ROMAO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MIDSTREAMS RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3837
Mailing Address - Country:US
Mailing Address - Phone:732-604-6227
Mailing Address - Fax:
Practice Address - Street 1:35 BEAVERSON BLVD STE 11
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7869
Practice Address - Country:US
Practice Address - Phone:866-557-8669
Practice Address - Fax:732-761-0305
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-29
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01001400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist