Individual
MR. EVAN DAVID ROMAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
9008 JAMAICA AVE, WOODHAVEN, NY 11421-2103
(718) 805-2020
(718) 805-2020
Mailing address
25115 52ND AVE, LITTLE NECK, NY 11362-1708
(718) 805-2020
(718) 805-2020
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
005731-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01615012
—
NY
Enumeration date
04/20/2006
Last updated
07/08/2007
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