Provider Demographics
NPI:1902025257
Name:ROMANO, JENNIFER ANN (MA, CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ANN
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MA, CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:839 NANCY WAY
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-3424
Mailing Address - Country:US
Mailing Address - Phone:908-301-0088
Mailing Address - Fax:718-871-6446
Practice Address - Street 1:839 NANCY WAY
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-3424
Practice Address - Country:US
Practice Address - Phone:908-301-0088
Practice Address - Fax:718-871-6446
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007579-1235Z00000X
NJYS3902235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJYS3902OtherLICENSE
NY007579-1OtherNYS LICENSE