Healthcare Provider Details

I. General information

NPI: 1699093054
Provider Name (Legal Business Name): ALLA ROITMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92 SUMMIT AVE
HACKENSACK NJ
07601-1263
US

IV. Provider business mailing address

1 W RIDGEWOOD AVE STE 205
PARAMUS NJ
07652-2361
US

V. Phone/Fax

Practice location:
  • Phone: 201-373-6453
  • Fax:
Mailing address:
  • Phone: 201-342-0066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09410600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: