Individual
ELIZABETH R ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 FRUIT ST, WHA, YAWKEY 4B, BOSTON, MA 02114-2621
(617) 724-6700
Mailing address
55 FRUIT ST, WHA, YAWKEY 4B, BOSTON, MA 02114-2621
(617) 724-6700
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
215929
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0027643
NEIGHBORHOOD HEATLH
MA
01
—
0179272
BLUE CROSS
MA
01
—
215929
TUFTS
MA
01
—
693127
HARVARD PILGRIM
MA
Enumeration date
06/27/2006
Last updated
10/19/2012
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