Organization
FAMILY PROVISION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FIORDALIZA ROMANO SLP (SPEECH-LANGUAGE PATHOLOGIST)
(917) 399-7281
Entity
Organization
Contact information
Practice address
81 INTERVALE RD, TEANECK, NJ 07666-6218
(917) 399-7281
Mailing address
81 INTERVALE RD, TEANECK, NJ 07666-6218
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
0188081
NY
305S00000X
Point of Service
Primary
41YS00600200
NJ
Other
Enumeration date
02/10/2017
Last updated
02/10/2017
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