Provider Demographics
NPI:1831314210
Name:ROMANO, JOSEPH PETER (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PETER
Last Name:ROMANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 GOVERNOR DR
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2698
Mailing Address - Country:US
Mailing Address - Phone:908-903-0286
Mailing Address - Fax:908-903-0345
Practice Address - Street 1:46 GOVERNOR DR
Practice Address - Street 2:
Practice Address - City:BASKING RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07920-2698
Practice Address - Country:US
Practice Address - Phone:908-903-0286
Practice Address - Fax:908-903-0345
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03349600207R00000X, 2083X0100X
NY1642912083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ17695784JMedicaid