Provider Demographics
NPI:1790016947
Name:ROMAN, MARIA YVETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:YVETTE
Last Name:ROMAN
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 1:53 SPIELMAN AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-5227
Mailing Address - Country:US
Mailing Address - Phone:516-567-6717
Mailing Address - Fax:
Practice Address - Street 1:53 SPIELMAN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-5227
Practice Address - Country:US
Practice Address - Phone:516-567-6717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6131891163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse