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Individual

S MOSHE ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
3111 US HIGHWAY 9, OLD BRIDGE, NJ 08857-2690
(732) 679-2020
(732) 679-2020
Mailing address
3111 US HIGHWAY 9, OLD BRIDGE, NJ 08857-2690
(732) 679-2020
(732) 679-6980

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OA00463500
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5021103
NJ
Enumeration date
07/08/2005
Last updated
05/12/2009
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