Provider Demographics
NPI:1912320219
Name:ROMANO, NICHOLAS FRANK (SLP)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:FRANK
Last Name:ROMANO
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 34TH ST APT 1114
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-2858
Mailing Address - Country:US
Mailing Address - Phone:239-384-2519
Mailing Address - Fax:
Practice Address - Street 1:205 34TH ST APT 1114
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-2858
Practice Address - Country:US
Practice Address - Phone:239-384-2519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2024-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 10986235Z00000X
VA2202010711235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA 10986Medicaid