Provider Demographics
NPI:1144068438
Name:ROMANOFF, TSARINA
Entity type:Individual
Prefix:
First Name:TSARINA
Middle Name:
Last Name:ROMANOFF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2478 GEORGE URBAN BLVD
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2010
Mailing Address - Country:US
Mailing Address - Phone:716-601-6220
Mailing Address - Fax:
Practice Address - Street 1:2478 GEORGE URBAN BLVD
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2010
Practice Address - Country:US
Practice Address - Phone:716-601-6220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP129457101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health