Provider Demographics
NPI:1174623136
Name:ROMANO, PAVAL (MD)
Entity type:Individual
Prefix:DR
First Name:PAVAL
Middle Name:
Last Name:ROMANO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2939
Mailing Address - Country:US
Mailing Address - Phone:631-549-5700
Mailing Address - Fax:631-549-1991
Practice Address - Street 1:175 E MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2939
Practice Address - Country:US
Practice Address - Phone:631-549-5700
Practice Address - Fax:631-549-1991
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217405207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00337716Medicare PIN
NY202AL0Z691Medicare PIN