Individual
DR. PHILIP ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(781) 226-9359
Mailing address
1 EDGEWATER ST, 6TH FL. PAYER RELATIONS, STATEN ISLAND, NY 10305-4900
(718) 226-1008
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
174445
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01145317
—
NY
Enumeration date
01/04/2006
Last updated
05/08/2008
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