Healthcare Provider Details

I. General information

NPI: 1831132455
Provider Name (Legal Business Name): MICHAEL A. ROTHSCHILD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 BROADWAY ROOM A1 - 9
ELMHURST NY
11373-1329
US

IV. Provider business mailing address

1175 PARK AVE SUITE 1A
NEW YORK NY
10128-1211
US

V. Phone/Fax

Practice location:
  • Phone: 718-334-4952
  • Fax: 718-334-4815
Mailing address:
  • Phone: 212-996-2995
  • Fax: 212-996-2703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number180375
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: