Provider Demographics
NPI:1770829582
Name:ROMAN, TANYA M (DC)
Entity Type:Individual
Prefix:DR
First Name:TANYA
Middle Name:M
Last Name:ROMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CALLE 1 STE 104 A
Mailing Address - Street 2:
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968-1708
Mailing Address - Country:US
Mailing Address - Phone:939-216-1606
Mailing Address - Fax:
Practice Address - Street 1:8 CALLE 1 STE 104 A
Practice Address - Street 2:METRO OFFICE PARK
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-1708
Practice Address - Country:US
Practice Address - Phone:939-216-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-26
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR505111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor