Provider Demographics
NPI:1477673911
Name:ROMANA, MARIA SOCCORSA (NP)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:SOCCORSA
Last Name:ROMANA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 W HENRIETTA RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14623-2327
Mailing Address - Country:US
Mailing Address - Phone:585-279-4958
Mailing Address - Fax:
Practice Address - Street 1:2613 W HENRIETTA RD
Practice Address - Street 2:SUITE A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-2327
Practice Address - Country:US
Practice Address - Phone:585-279-4958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY400773363LP0808X
NYF400773-1363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health