Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 25MA11164300 | NJ |
N | 208000000X | Pediatrician | DR.0060198 | CO |
Y | 2080P0205X | Pediatric Endocrinologist | 25MA11164300 | NJ |
NPI | 1033598370 |
---|---|
Provider Name | Shoshana Sophie Rothman Tell |
First Address | Hackensack, NJ 07601-1915 |
Second Address | Hackensack, NJ 07601-1915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2015 |
Last Update Date | 20/08/2021 |