Provider Demographics
NPI:1689846115
Name:ROMANO, MICHELLE J (RN)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:J
Last Name:ROMANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 RIDGEWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:FARMINGVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11738-1618
Mailing Address - Country:US
Mailing Address - Phone:631-696-3211
Mailing Address - Fax:
Practice Address - Street 1:153 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:FARMINGVILLE
Practice Address - State:NY
Practice Address - Zip Code:11738-1618
Practice Address - Country:US
Practice Address - Phone:631-696-3211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY525279-1163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical