Individual
LISA MARIE ROMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
622 W 168TH ST, NEW YORK, NY 10032-3720
(212) 305-2500
Mailing address
31 CHESTER LN, NANUET, NY 10954-3837
(845) 536-4878
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
0059701
NY
133V00000X
Registered Dietitian
Primary
934547
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400011781
MEDICARE PTAN
NY
01
—
WZZZR1
MEDICARE GROUP
NY
Enumeration date
12/04/2008
Last updated
09/02/2009
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