Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 25MA08297500 | NJ |
NPI | 1285722900 |
---|---|
Provider Name | Dr. Michael Anthony Romello |
First Address | Red Bank, NJ 07701-5727 |
Second Address | Red Bank, NJ 07701-5727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 19/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I64737 | (02) |