Provider Demographics
NPI:1073640249
Name:ROTHMAN, ALLEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:S
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 HUGENOT STREET
Mailing Address - Street 2:SUITE #36
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801
Mailing Address - Country:US
Mailing Address - Phone:914-633-4070
Mailing Address - Fax:914-633-4139
Practice Address - Street 1:421 HUGENOT STREET
Practice Address - Street 2:SUITE #36
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801
Practice Address - Country:US
Practice Address - Phone:914-633-4070
Practice Address - Fax:914-633-4139
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29106208600000X
NY119712208600000X
CT17018208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCB229232OtherWORKERS COMP
NY00335415Medicaid
348952Medicare ID - Type Unspecified
C08960Medicare UPIN