Healthcare Provider Details

I. General information

NPI: 1164543948
Provider Name (Legal Business Name): ADRIA ROTHFELD D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 06/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 ROUTE 34 SUITE 104
COLTS NECK NJ
07722
US

IV. Provider business mailing address

1944 RICHMOND AVE
STATEN ISLAND NY
10314-3914
US

V. Phone/Fax

Practice location:
  • Phone: 732-308-3030
  • Fax: 732-308-3081
Mailing address:
  • Phone: 718-370-7500
  • Fax: 718-370-0850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License NumberX005405
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: