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Individual
JEROME K ROTH JR.
Active
Individual
JEROME K ROTH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
019211
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001192111
—
CT
Enumeration date
02/08/2006
Last updated
03/30/2016
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