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General NPI Number Information
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NPI Number | 1700364163
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Entity Type | Individual
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Provider Name | ALISON LEIGH ROTHENBERG
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Gender | Female
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Dates
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Enumeration Date | 07/29/2018
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Last Update Date | 07/29/2018
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Provider Practice Location Address
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Address Line | 300 GARDEN CITY PLZ
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City | GARDEN CITY
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State | NY
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Zip | 11530-3302
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Country | US
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Telephone | 516-747-9030
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Fax |
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Provider Business Mailing Address
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Address Line | 2841 BESADE CT
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City | OCEANSIDE
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State | NY
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Zip | 11572-1007
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Country | US
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Telephone | 516-351-6096
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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