Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | MA25049 | NJ |
NPI | 1316903313 |
---|---|
Provider Name | Dr. Nicholas Alexander Romanoff |
First Address | Cherry Hill, NJ 08034 |
Second Address | Cherry Hill, NJ 08034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 11/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1161601 | (05) | NJ |
AR5259622 | BNDD (01) | |
C58866 | (02) |