Provider Demographics
NPI:1396531315
Name:ROMAN, MICHAEL NADER
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NADER
Last Name:ROMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1476 VARELAS PASS
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:OAKVILLE
Mailing Address - Zip Code:L6H3S3
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 ELM ST
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776
Practice Address - Country:US
Practice Address - Phone:860-210-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program