Individual
DR. KENNETH ROISTACHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7672
(718) 869-8530
Mailing address
327 BEACH 19TH ST, FAR ROCKAWAY, NY 11691-4423
(718) 869-7672
(718) 869-8530
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
149111
NY
Other
Enumeration date
11/13/2006
Last updated
02/03/2014
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