Provider Demographics
NPI:1982073599
Name:ROMA RAJS PHYSICIAN PC
Entity Type:Organization
Organization Name:ROMA RAJS PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROMA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJS-NEPOMNIASHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-597-9724
Mailing Address - Street 1:2951 OCEAN AVE
Mailing Address - Street 2:APT 2A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3275
Mailing Address - Country:US
Mailing Address - Phone:917-597-9724
Mailing Address - Fax:
Practice Address - Street 1:9732 63RD RD
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1639
Practice Address - Country:US
Practice Address - Phone:718-275-2224
Practice Address - Fax:718-275-5600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty