Provider Demographics
NPI:1245263441
Name:KULIKOVA, ROMANA (MD)
Entity type:Individual
Prefix:DR
First Name:ROMANA
Middle Name:
Last Name:KULIKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROMANA
Other - Middle Name:
Other - Last Name:KULIKOVA-SCHUPAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:400 CENTER ST.
Mailing Address - Street 2:
Mailing Address - City:GARWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07027
Mailing Address - Country:US
Mailing Address - Phone:908-232-0200
Mailing Address - Fax:908-232-0211
Practice Address - Street 1:400 CENTER ST.
Practice Address - Street 2:
Practice Address - City:GARWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07027
Practice Address - Country:US
Practice Address - Phone:908-232-0200
Practice Address - Fax:908-232-0211
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079700002084N0402X
NY2243712084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I45183Medicare UPIN
NJ095853Medicare ID - Type Unspecified