Individual
MONIQUE E ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 LYONS ST, DEDHAM, MA 02026-5599
(781) 329-1400
(781) 278-5667
Mailing address
PO BOX 9120, DEDHAM, MA 02027-9120
(781) 329-1400
(781) 278-5667
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
75907
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014523
NEIGHBORHOOD HEALTH PLAN
—
01
—
0300320
UNITED HEALTHCARE(HMO/PPO
—
01
—
070013072
RAILROAD MEDICARE
—
01
—
075907
TUFTS
—
01
—
2733572
HEALTHSOURCE
MA
01
—
2733572
CIGNA HEALTH CARE
—
01
—
27684
CHILDREN'S MED. SECURITY
—
01
—
3193B70
MASS.HEALTH(DIV.MEDSVCS)
—
01
—
401095
HARVARD PILGRIM PPO
—
01
—
G17464
FIRST SENIORITY
—
01
—
J16188
BLUE SHIELD INDEMNITY
—
Enumeration date
06/30/2005
Last updated
08/10/2010
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