Provider Demographics
NPI:1750607511
Name:ROMAN, KRISTIN GILMORE (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:GILMORE
Last Name:ROMAN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:460 BRIELLE AVE
Mailing Address - Street 2:OFFICE OF THE CHIEF MEDICAL EXAMINER
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314
Mailing Address - Country:US
Mailing Address - Phone:718-668-0620
Mailing Address - Fax:718-668-0647
Practice Address - Street 1:460 BRIELLE AVE
Practice Address - Street 2:OFFICE OF THE CHIEF MEDICAL EXAMINER
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314
Practice Address - Country:US
Practice Address - Phone:718-668-0620
Practice Address - Fax:718-668-0647
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
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Provider Licenses
StateLicense IDTaxonomies
NY221328207ZF0201X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology