Individual
JACQUELINE ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
136 CRANBERRY CT, MELVILLE, NY 11747-8722
(631) 470-2531
Mailing address
575 UNDERHILL BLVD STE 190, SYOSSET, NY 11791-3494
(516) 364-9800
(516) 364-9802
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310462-01
NY
Other
Enumeration date
10/12/2021
Last updated
01/16/2022
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