MEDICARE: VALERIE ROTH P.T.

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
1	225100000X	Physical Therapist	002065-1	NY

General Provider Information

NPI Number	:	1841322377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIE ROTH P.T.

Provider Business Mailing Address
First Line	:	70 BARKER ST
Second Line	:	#204
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-1710
Country	:	US
Telephone Number	:	914-244-9077
Fax Number	:

Provider Business Practice Location Address
First Line	:	3535 HILL BLVD
Second Line	:	SUITE P
City	:	YORKTOWN HEIGHTS
State	:	NY
Zip	:	10598-1293
Country	:	US
Telephone Number	:	914-962-2728
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2007
Last Update Date	:	07/08/2007

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