Provider Demographics
NPI:1609971480
Name:ROMANO, JUDITH T (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:T
Last Name:ROMANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:222 N 5TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MARTINS FERRY
Mailing Address - State:OH
Mailing Address - Zip Code:43935-1582
Mailing Address - Country:US
Mailing Address - Phone:740-633-6480
Mailing Address - Fax:740-633-6475
Practice Address - Street 1:222 N 5TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:MARTINS FERRY
Practice Address - State:OH
Practice Address - Zip Code:43935-1582
Practice Address - Country:US
Practice Address - Phone:740-633-6480
Practice Address - Fax:740-633-6475
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35077419208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0106704000Medicaid
OH0787162Medicaid