Organization
SCOTT L. ROTH M.D, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SCOTT LEONARD ROTH M.D. (OWNER)
(585) 426-4160
Entity
Organization
Contact information
Practice address
1012 ELMGROVE RD, ROCHESTER, NY 14624-1324
(585) 426-4160
(585) 426-4167
Mailing address
1012 ELMGROVE RD, ROCHESTER, NY 14624-1324
(585) 426-4160
(585) 426-4167
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
150586
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01449238
—
NY
Enumeration date
09/13/2007
Last updated
09/13/2007
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