Provider Demographics
NPI:1972843696
Name:ROMULUS, MARIE MACCIANA (LPN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:MACCIANA
Last Name:ROMULUS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37B SEABRING ST
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5132
Mailing Address - Country:US
Mailing Address - Phone:845-406-8922
Mailing Address - Fax:
Practice Address - Street 1:37B SEABRING ST
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5132
Practice Address - Country:US
Practice Address - Phone:845-406-8922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NP05550700164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse