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Organization

ASSOCIATED NORTHWEST UROLOGY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEROME KARL ROTH M.D. (PRESIDENT)
(860) 364-0225
Entity
Organization

Contact information

Practice address
17 HOSPITAL HILL RD, SHARON, CT 06069-2010
(860) 364-0225
(860) 364-1736
Mailing address
PO BOX 1736, 17 HOSPITAL HILL RD, SHARON, CT 06069-1736
(860) 364-0225
(860) 364-1736

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
019211
CT

Other

Enumeration date
01/31/2007
Last updated
05/02/2008
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