Individual
CHRISTIAN ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, AGNP-C
Contact information
Practice address
VASCULAR SURGERY HSC T19-090, STONY BROOK, NY 11794-8191
(631) 444-2037
Mailing address
155 DIVISION AVE, WEST SAYVILLE, NY 11796-1313
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
308297
NY
Other
Enumeration date
01/15/2018
Last updated
01/15/2018
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