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NPI Code Detail

MEDICARE: MRS. INGER ROTHPEARL RN

MEDICARE: MRS. INGER ROTHPEARL RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse475676-1NY

General Provider Information

NPI Number : 1083983332
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. INGER ROTHPEARL RN
Provider Business Mailing Address
First Line : 205 BURNHAM ST
Second Line :
City : NEWARK
State : NY
Zip : 14513-1912
Country : US
Telephone Number : 315-331-7601
Fax Number :
Provider Business Practice Location Address
First Line : 439 W MAPLE AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-2062
Country : US
Telephone Number : 315-332-3312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2011
Last Update Date : 12/15/2011

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