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Individual

DR. LINDA ROETHEL

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
196 MERRICK RD, OCEANSIDE, NY 11572-1420
(516) 255-1616
(516) 255-4672
Mailing address
1 HEALTHY WAY, ATTN: PHYSICIAN BILLING DEPT, OCEANSIDE, NY 11572-1551
(516) 255-1600
(516) 255-4672

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
184344
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000071571
GHI HMO
NY
05
01425149
NY
01
0D4451
BCBS
NY
01
1000021935
AFFINITY
NY
01
184344
HIP
NY
01
2C9292
HEALTHNET
NY
01
5022479
AETNA PPO
NY
01
519648
AETNA HMO
NY
01
5782299
CIGNA
NY
01
5903664
GHI PPO
NY
01
AA71640
MDNY
NY
01
GP160
OXFORD
NY
Enumeration date
09/16/2005
Last updated
07/08/2007
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