Provider Demographics
NPI:1558556795
Name:RICHARD W ROMASH
Entity Type:Organization
Organization Name:RICHARD W ROMASH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMASH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:856-427-9311
Mailing Address - Street 1:PO BOX 881
Mailing Address - Street 2:
Mailing Address - City:HADDONFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08033-0569
Mailing Address - Country:US
Mailing Address - Phone:856-427-9311
Mailing Address - Fax:856-427-9310
Practice Address - Street 1:76 E EUCLID AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033-2330
Practice Address - Country:US
Practice Address - Phone:856-427-9311
Practice Address - Fax:856-427-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA000268400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ094982Medicare PIN