Individual
JULIE L ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, APC-5, PROVIDENCE, RI 02903-4923
(401) 444-3032
(401) 444-3205
Mailing address
15 LA SALLE SQ, PROVIDENCE, RI 02903-1814
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
MD12830
RI
2084N0600X
Clinical Neurophysiology Physician
Primary
MD12830
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063673713
—
RI
05
—
110084239A
—
MA
Enumeration date
06/24/2008
Last updated
12/18/2025
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