Provider Demographics
NPI:1518985761
Name:ROMEO, MARYBETH FILISKY (PT)
Entity Type:Individual
Prefix:
First Name:MARYBETH
Middle Name:FILISKY
Last Name:ROMEO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MARYBETH
Other - Middle Name:
Other - Last Name:FILISKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:510 W MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1454
Mailing Address - Country:US
Mailing Address - Phone:330-702-0110
Mailing Address - Fax:330-702-0510
Practice Address - Street 1:4137 BOARDMAN CANFIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8088
Practice Address - Country:US
Practice Address - Phone:330-286-3850
Practice Address - Fax:330-286-3852
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2127479Medicaid
OHRO0885133Medicare PIN