Provider Demographics
NPI:1841432424
Name:ROMAN, STEFANIE (MS OTR/L)
Entity type:Individual
Prefix:MISS
First Name:STEFANIE
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22421 KINGSBURY AVE
Mailing Address - Street 2:APT B
Mailing Address - City:OAKLAND GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-3626
Mailing Address - Country:US
Mailing Address - Phone:917-270-5501
Mailing Address - Fax:
Practice Address - Street 1:22421 KINGSBURY AVE
Practice Address - Street 2:APT B
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-3626
Practice Address - Country:US
Practice Address - Phone:917-270-5501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13127171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor