Provider Demographics
NPI:1467506113
Name:ROMANO, PHILIP (DC)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:ROMANO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3299 FLORENCE RD
Mailing Address - Street 2:
Mailing Address - City:WOODBINE
Mailing Address - State:MD
Mailing Address - Zip Code:21797
Mailing Address - Country:US
Mailing Address - Phone:301-924-6444
Mailing Address - Fax:
Practice Address - Street 1:18120 HILLCREST AVE
Practice Address - Street 2:SUITE D
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1420
Practice Address - Country:US
Practice Address - Phone:301-924-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01881111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD490084Medicare ID - Type Unspecified