Individual
JENNIFER LOBBAN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 WAYNE AVE, APT 13H, BRONX, NY 10467-2510
(305) 979-8001
Mailing address
3450 WAYNE AVE, APT 13H, BRONX, NY 10467-2510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
390200000X.
NY
Other
Enumeration date
09/09/2011
Last updated
09/09/2011
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