Provider Demographics
NPI:1356419170
Name:BROWN- MEDFORD, ROMAINE KAREN (RN)
Entity type:Individual
Prefix:MRS
First Name:ROMAINE
Middle Name:KAREN
Last Name:BROWN- MEDFORD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:57 WESTERVELT AVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2014
Mailing Address - Country:US
Mailing Address - Phone:718-993-3458
Mailing Address - Fax:719-993-3948
Practice Address - Street 1:408 E 137TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-4004
Practice Address - Country:US
Practice Address - Phone:718-993-3458
Practice Address - Fax:718-993-3948
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY433633163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse