Basic Information
| Provider Information | |||||||||
| NPI: | 1881988053 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROMAN | ||||||||
| FirstName: | ROBYN | ||||||||
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| Credential: | COTA/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 64 DANBURY ROAD | ||||||||
| Address2: | ONWARD HEALTHCARE | ||||||||
| City: | WILTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002780332 | ||||||||
| FaxNumber: | 8009705001 | ||||||||
| Practice Location | |||||||||
| Address1: | 64 DANBURY ROAD | ||||||||
| Address2: | ONWARD HEALTHCARE | ||||||||
| City: | WILTON | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06897 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002780332 | ||||||||
| FaxNumber: | 8009705001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2011 | ||||||||
| LastUpdateDate: | 06/06/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | OTA11086 | FL | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | 224Z00000X | OTA 11086 | FL | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.