Provider Demographics
NPI:1871296525
Name:JOHN, ROMA (APRN, NP)
Entity type:Individual
Prefix:
First Name:ROMA
Middle Name:
Last Name:JOHN
Suffix:
Gender:F
Credentials:APRN, NP
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:2466 E CHESTNUT AVE STE 2
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8486
Practice Address - Country:US
Practice Address - Phone:856-691-2211
Practice Address - Fax:856-839-4128
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2024-10-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01460400363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner