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NPI Code Detail

MEDICARE: DR. STEVEN DAVID ROTH M.D.

MEDICARE: DR. STEVEN DAVID ROTH M.D.
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
12084P0800XPsychiatry Physician150495NY

General Provider Information

NPI Number : 1679578785
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEVEN DAVID ROTH M.D.
Provider Business Mailing Address
First Line : 24 PARK RD
Second Line :
City : SCARSDALE
State : NY
Zip : 10583-2142
Country : US
Telephone Number : 914-997-5720
Fax Number : 914-682-5494
Provider Business Practice Location Address
First Line : 21 BLOOMINGDALE RD
Second Line :
City : WHITE PLAINS
State : NY
Zip : 10605-1504
Country : US
Telephone Number : 914-997-5720
Fax Number : 914-682-5494
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 12/19/2011

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