Provider Demographics
NPI:1144470345
Name:ROMANOWICZ, MAGDALENA (MD)
Entity type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:ROMANOWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-288-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:MAYO CLINIC
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-3600
Practice Address - Country:US
Practice Address - Phone:507-284-5849
Practice Address - Fax:507-284-9480
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 1170312084P0800X
NH160232084P0804X
390200000X
MN531702084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN260003356Medicare PIN