Individual
DR. JESSICA R ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
75 BICKFORD ST, JAMAICA PLAIN, MA 02130-1401
(617) 971-2100
Mailing address
78 ELM ST, CAMBRIDGE, MA 02139-1403
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
82155
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3148080
—
MA
Enumeration date
11/14/2006
Last updated
07/08/2007
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