Individual
KATHERINE G ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12 MEDICAL DR, STE D, PORT JEFFERSON STATION, NY 11776-1588
(631) 928-1222
(631) 928-8605
Mailing address
12 MEDICAL DR, STE D, PORT JEFFERSON STATION, NY 11776-1588
(631) 928-1222
(631) 928-8605
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
207319
NY
Other
Enumeration date
11/07/2005
Last updated
09/05/2024
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