Individual
KATHLEEN MARIE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5201 BAUM BLVD, SHADYSIDE MEDEXPRESS, PITTSBURGH, PA 15224-2303
(412) 687-3627
Mailing address
389 BANBURY DR, ROCHESTER, NY 14612-5918
(585) 705-7214
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA055869
PA
Other
Enumeration date
12/28/2012
Last updated
12/28/2012
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