Individual
MRS. CARLY JILL ROME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5 COLUMBUS CIRCLE, 8TH FLOOR, NEW YORK, NY 10019-1412
(212) 590-5580
(212) 590-5581
Mailing address
555 W 23RD ST APT S12F, NEW YORK, NY 10011-1027
(203) 980-5958
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021097
LICENSE
NY
Enumeration date
08/04/2017
Last updated
10/29/2018
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