Basic Information
Provider Information
NPI: 1790936367
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROMINGER
FirstName: AMY
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 925 CHESTNUT ST
Address2: 6TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191074216
CountryCode: US
TelephoneNumber: 2159556760
FaxNumber: 2159234532
Practice Location
Address1: 925 CHESTNUT ST
Address2: 6TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191074216
CountryCode: US
TelephoneNumber: 2159556760
FaxNumber: 2159234532
Other Information
ProviderEnumerationDate: 10/01/2008
LastUpdateDate: 10/01/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XAT006093PAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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