Individual
PETER MARTIN ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1347
(516) 562-6000
Mailing address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1347
(516) 562-6000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
028473
NY
Other
Enumeration date
07/12/2022
Last updated
07/12/2022
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