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General NPI Number Information
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NPI Number | 1538132352
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Entity Type | Individual
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Provider Name | DANIEL B ROTH MD
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Gender | Male
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 08/01/2017
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Provider Practice Location Address
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Address Line | 10 PLUM ST SUITE 600
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-2065
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Country | US
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Telephone | 732-220-1600
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Fax | 732-220-1603
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Provider Business Mailing Address
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Address Line | 1700 GALLOPING HILL RD
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City | KENILWORTH
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State | NJ
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Zip | 07033-1303
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Country | US
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Telephone | 908-458-8334
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Fax | 908-298-0104
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 71092
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number | 25MA07109200
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License Number State | NJ
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