Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 455453 | PA |
N | 207VE0102X | Reproductive Endocrinologist | D0080004 | MD |
NPI | 1417003047 |
---|---|
Provider Name | Lauren Roth |
First Address | Rockville, MD 20850-3655 |
Second Address | Camp Hill, PA 17011-3707 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2007 |
Last Update Date | 22/08/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80433782 | (05) | CO |