Individual
DR. MATTHEW EVAN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
225 BROADWAY STE 2130, NEW YORK, NY 10007-3733
(646) 926-4849
Mailing address
225 BROADWAY STE 2130, NEW YORK, NY 10007-3733
(646) 926-4849
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
021931
NY
103T00000X
Psychologist
40079
TX
103T00000X
Psychologist
TPPY2475
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
08/21/2014
Last updated
12/06/2023
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