Individual
CHARLES B ROTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
42084 STATE HIGHWAY 28, MARGARETVILLE, NY 12455-2820
(845) 586-2631
(845) 586-2976
Mailing address
42084 STATE HIGHWAY 28, MARGARETVILLE, NY 12455-2820
(845) 586-2631
(845) 586-2976
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
000212
NY
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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