Individual
JESSICA ROMANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 HORSEBLOCK RD STE H, FARMINGVILLE, NY 11738-1252
(631) 233-9490
Mailing address
400 HORSEBLOCK RD STE H, FARMINGVILLE, NY 11738-1252
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404413
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
404413
NON MEDICARE AND NON MEDICAID PROVIDER
—
Enumeration date
08/29/2022
Last updated
08/29/2022
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