Provider Demographics
NPI:1821410861
Name:ROMAKO, CAROLYN (LAC)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:ROMAKO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5521 CARLISLE PIKE
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-2419
Mailing Address - Country:US
Mailing Address - Phone:717-697-7058
Mailing Address - Fax:
Practice Address - Street 1:5521 CARLISLE PIKE
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-2419
Practice Address - Country:US
Practice Address - Phone:717-697-7058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2014-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001076171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist