Individual
DR. JONATHAN MICHAEL ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 HAMBURG TPKE, WAYNE, NJ 07470-3235
(973) 616-0200
Mailing address
P.O. BOX 416457, BOSTON, MA 02241-6457
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
25MA10080100
NJ
Other
Enumeration date
10/20/2006
Last updated
04/12/2019
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