Individual
DR. LARRY H ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 MOUNT AUBURN ST, WATERTOWN, MA 02472-4191
(617) 923-4400
(617) 926-4549
Mailing address
521 MOUNT AUBURN ST, WATERTOWN, MA 02472-4191
(617) 923-4400
(617) 926-4549
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
40273
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2068672
—
MA
Enumeration date
01/02/2007
Last updated
07/08/2007
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