Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 47616 020 | WI |
NPI | 1831163963 |
---|---|
Provider Name | Dr. Alexander A Romashko |
First Address | New Berlin, WI 53151-7401 |
Second Address | New Berlin, WI 53151-7401 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 24/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1831163963 | (05) | WI |
I37778 | (02) |