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NPI Code Detail

MEDICARE: NORMAN ROTH M.S., M.D.

MEDICARE:   NORMAN  ROTH  M.S., M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician63322CT

General Provider Information

NPI Number : 1568828259
Entity Type Code : Individual
Provider Name (Legal Business Name) : NORMAN ROTH M.S., M.D.
Provider Business Mailing Address
First Line : 1062 BARNES RD
Second Line : STE 300
City : WALLINGFORD
State : CT
Zip : 06492-2576
Country : US
Telephone Number : 203-265-9831
Fax Number :
Provider Business Practice Location Address
First Line : 1062 BARNES RD STE 300
Second Line :
City : WALLINGFORD
State : CT
Zip : 06492-2576
Country : US
Telephone Number : 605-251-5328
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2016
Last Update Date : 01/16/2020

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Directions to “ NORMAN ROTH M.S., M.D.” Practice Location

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