Basic Information
| Provider Information | |||||||||
| NPI: | 1487208625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMANO | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | AMBER | ||||||||
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| Credential: | MHS, PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 SAVORY LN | ||||||||
| Address2: | |||||||||
| City: | NORTH WALES | ||||||||
| State: | PA | ||||||||
| PostalCode: | 194541636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155912674 | ||||||||
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| Practice Location | |||||||||
| Address1: | 915 LAWN AVE | ||||||||
| Address2: | |||||||||
| City: | SELLERSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189601551 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2152573700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2019 | ||||||||
| LastUpdateDate: | 07/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | MA060588 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.