Provider Demographics
NPI:1700143351
Name:ROMANO, MADELINE ROSE (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MADELINE
Middle Name:ROSE
Last Name:ROMANO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:MADELINE
Other - Middle Name:ROSE
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:316 HAMPTON GRN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312
Mailing Address - Country:US
Mailing Address - Phone:917-991-9406
Mailing Address - Fax:
Practice Address - Street 1:21 GARLAND CT
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-5942
Practice Address - Country:US
Practice Address - Phone:718-743-0180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-20
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist