Individual
DR. LESLIE AILEEN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
208 COLLYER ST, SUITE 302, PROVIDENCE, RI 02904-1560
(401) 553-8312
(401) 868-2306
Mailing address
PO BOX 16149, RUMFORD, RI 02916-0697
(401) 453-9625
(401) 435-7069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD429123
PA
208C00000X
Colon & Rectal Surgery Physician
Primary
MD12703
RI
Other
Enumeration date
03/30/2007
Last updated
01/29/2020
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