Provider Demographics
NPI:1770683104
Name:ROMANENKO, MARIA O (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:O
Last Name:ROMANENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAMILTON HEALTH PL
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-3542
Mailing Address - Country:US
Mailing Address - Phone:609-586-7900
Mailing Address - Fax:
Practice Address - Street 1:801 OSTRUM ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18015-1000
Practice Address - Country:US
Practice Address - Phone:484-526-4500
Practice Address - Fax:484-526-6674
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37037207P00000X
PAMD447883207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32559000Medicaid
WI010451025Medicare ID - Type Unspecified
WI32559000Medicaid