# KIMBERLY A. ROMAINE, DC, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780907907
- **Authorized official:** DR. KIMBERLY ANNE ROMAINE D.C. (CHIROPRACTOR/OWNER)
- **Authorized official phone:** (631) 281-0966

## Contact information

- **Practice address:** 283 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-3467
- **Practice address phone:** (631) 281-0966
- **Practice address fax:** (631) 281-0970
- **Mailing address:** 283 WILLIAM FLOYD PKWY, SHIRLEY, NY 11967-3467
- **Mailing address phone:** (631) 281-0966
- **Mailing address fax:** (631) 281-0970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | X004616-1 | NY | Yes |

## Other

- **Enumeration date:** 03/02/2010
- **Last updated:** 03/02/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | X42801 | MEDICARE PTAN | NY |