Individual
MR. JONATHAN ALEXANDER ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, NP, CVRN-BC
Contact information
Practice address
1000 MONTAUK HWY, WEST ISLIP, NY 11795-4927
(631) 376-3000
Mailing address
64 SILVER ST, WEST BABYLON, NY 11704-3925
(631) 383-2070
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310969
NY
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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