Individual
JUDITH G ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
164 BLACKHEATH RD, LIDO BEACH, NY 11561-4840
(516) 431-2636
(516) 432-5841
Mailing address
164 BLACKHEATH RD, LIDO BEACH, NY 11561-4840
(516) 431-2636
(516) 432-5841
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
XOO4297
NY
Other
Enumeration date
12/20/2005
Last updated
05/20/2008
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