Provider Demographics
NPI:1467428615
Name:ROMANOWSKY, DIANE P (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:DIANE
Middle Name:P
Last Name:ROMANOWSKY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DR
Mailing Address - Street 2:DEPT. OF PLASTIC SURGERY, H071
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-2360
Mailing Address - Country:US
Mailing Address - Phone:717-531-4340
Mailing Address - Fax:717-531-4339
Practice Address - Street 1:500 UNIVERSITY DR
Practice Address - Street 2:DEPT. OF PLASTIC SURGERY, H071
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-2360
Practice Address - Country:US
Practice Address - Phone:717-531-4340
Practice Address - Fax:717-531-4339
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA001401L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
078878Medicare ID - Type Unspecified
S13836Medicare UPIN