Provider Demographics
NPI:1720104672
Name:ROBERT M ROMANOFF MD PC
Entity Type:Organization
Organization Name:ROBERT M ROMANOFF MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROMANOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-877-2100
Mailing Address - Street 1:115 CENTRAL PARK WEST
Mailing Address - Street 2:STE 14
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-877-2100
Mailing Address - Fax:212-873-9311
Practice Address - Street 1:115 CENTRAL PARK WEST
Practice Address - Street 2:STE 14
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-877-2100
Practice Address - Fax:212-873-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY142928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY77A242Medicare PIN
NYB19273Medicare UPIN
NY362J21Medicare ID - Type Unspecified