Provider Demographics
NPI:1942620695
Name:ROMMENEY, MARISA (DO)
Entity type:Individual
Prefix:DR
First Name:MARISA
Middle Name:
Last Name:ROMMENEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 SUMMER ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905
Mailing Address - Country:US
Mailing Address - Phone:203-324-4109
Mailing Address - Fax:203-969-1271
Practice Address - Street 1:1275 SUMMER ST
Practice Address - Street 2:SUITE 301
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905
Practice Address - Country:US
Practice Address - Phone:203-324-4109
Practice Address - Fax:203-969-1271
Is Sole Proprietor?:No
Enumeration Date:2014-04-21
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY269034208000000X
CT053077208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics