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NPI Code Detail

MEDICARE: ILANA ROTHSTEIN MD

MEDICARE:   ILANA  ROTHSTEIN  MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1740030535
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILANA ROTHSTEIN MD
Provider Business Mailing Address
First Line : 664 STONELEIGH AVENUE
Second Line : PSYCHIATRY GME SUITE 301
City : CARMEL
State : NY
Zip : 10512-2450
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 664 STONELEIGH AVENUE
Second Line : PSYCHIATRY GME SUITE 301
City : CARMEL
State : NY
Zip : 10512-2450
Country : US
Telephone Number : 845-790-1321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2024
Last Update Date : 03/25/2024

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