Physician Compare National (NPI:1700884889)

HEALTHCARE PROVIDER: MARC ROTHMAN MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1700884889
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901975457
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111206000252
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROTHMAN
	Individual professional last name
Provider First Name	MARC
	Individual professional first name
Provider Middle Name	IRWIN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	216 HADDON AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 706
	Group Practice or individual's line 2 address
City	HADDON TOWNSHIP
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	081082815
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8564270553
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310061
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LOURDES MEDICAL CENTER OF BURLINGTON COUNTY
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y