Provider Demographics
NPI:1932177623
Name:ROMANOSKI, REGAN BRYNN (PT)
Entity Type:Individual
Prefix:MS
First Name:REGAN
Middle Name:BRYNN
Last Name:ROMANOSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 VILLAGE VIEW BLVD APT 101
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-3811
Mailing Address - Country:US
Mailing Address - Phone:845-325-0108
Mailing Address - Fax:
Practice Address - Street 1:25241 ELEMENTARY WAY STE 200
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34135-7883
Practice Address - Country:US
Practice Address - Phone:239-947-4184
Practice Address - Fax:239-947-4171
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0240911225100000X
FLPT36783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist