Individual
CHARLES ROTHBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 EAST MAIN ST, PATCHOGUE, NY 11772
(631) 758-5300
(631) 758-5301
Mailing address
331 EAST MAIN ST, PATCHOGUE, NY 11772
(631) 758-5300
(631) 758-5301
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
165064
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01020864
—
NY
01
—
01E642
EMPIRE BCBS
NY
01
—
1688
VYTRA HEALTHCARE
—
01
—
CS755
OXFORD HEALTHCARE
—
Enumeration date
10/03/2006
Last updated
02/13/2008
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