Individual
EILEEN ROTHROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3430 HUNTINGDON PIKE, HUNTINGDON VALLEY, PA 19006
(215) 938-7171
(215) 938-7338
Mailing address
350 CRABTREE DR, LEVITTOWN, PA 19007
(215) 547-1871
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
VP006491C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R01817831
BLUE SHIELD
PA
Enumeration date
11/06/2006
Last updated
07/08/2007
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