Individual
DR. MALCOLM ZACHARY ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Contact information
Practice address
925 49TH ST, 1ST FLOOR, BROOKLYN, NY 11219-2923
(718) 283-7022
(718) 283-8123
Mailing address
925 49TH ST, 1ST FLOOR, BROOKLYN, NY 11219-2923
(718) 283-7022
(718) 283-8123
Taxonomy
Speciality
Code
Description
License number
State
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
158057
NY
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
158057
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015625
GHI
—
05
—
01094444
—
NY
01
—
26E721
BCBS
—
Enumeration date
08/09/2006
Last updated
08/02/2011
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