Individual
JEFFREY M ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
725 ERIE BLVD W, SYRACUSE, NY 13204-2229
(315) 475-2778
(315) 471-3522
Mailing address
725 ERIE BLVD W, SYRACUSE, NY 13204-2229
(315) 475-2778
(315) 471-3522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002684
CT
152W00000X
Optometrist
Primary
006532
NY
Other
Enumeration date
05/31/2006
Last updated
01/04/2010
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