Provider Demographics
NPI:1740212422
Name:ROMAINE, ROBERT M (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:ROMAINE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 ST AGNES HWY
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-3927
Mailing Address - Country:US
Mailing Address - Phone:518-233-0669
Mailing Address - Fax:
Practice Address - Street 1:99 ST AGNES HWY
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-3927
Practice Address - Country:US
Practice Address - Phone:518-233-0669
Practice Address - Fax:518-233-1712
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002639-1213E00000X, 213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4800022212OtherRAILROAD MEDICARE
NY4800022212OtherRAILROAD MEDICARE
NY0825180001Medicare NSC
NYT26371Medicare UPIN