Provider Demographics
NPI:1700068038
Name:DIANE M. ROMANO NP, ADULT HEALTH PC
Entity Type:Organization
Organization Name:DIANE M. ROMANO NP, ADULT HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CALANDRINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-424-3600
Mailing Address - Street 1:23 BLACK GUM TREE LN
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-1746
Mailing Address - Country:US
Mailing Address - Phone:631-424-3600
Mailing Address - Fax:
Practice Address - Street 1:110 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2845
Practice Address - Country:US
Practice Address - Phone:631-424-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303591-1364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2E8021Medicare PIN