Organization
ROTH & RUSSIN LLC
Active
Other names
Main Line Eye Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD E ROTH DO (OWNER)
(610) 687-6888
Entity
Organization
Contact information
Practice address
124 BLOOMINGDALE AVE, WAYNE, PA 19087-3929
(610) 687-6888
(610) 687-1120
Mailing address
124 BLOOMINGDALE AVE, WAYNE, PA 19087-3929
(610) 687-6888
(610) 687-1120
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1654669
HIGHMARK NUMBER
PA
Enumeration date
07/27/2006
Last updated
08/22/2020
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