Provider Demographics
NPI:1457950917
Name:ROMAN, CHRISTINE (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ROBIN LN
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-4058
Mailing Address - Country:US
Mailing Address - Phone:609-317-0653
Mailing Address - Fax:
Practice Address - Street 1:1560 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3521
Practice Address - Country:US
Practice Address - Phone:732-493-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-25
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03929800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist