Provider Demographics
NPI:1083983332
Name:ROTHPEARL, INGER (RN)
Entity Type:Individual
Prefix:MRS
First Name:INGER
Middle Name:
Last Name:ROTHPEARL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 BURNHAM ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1912
Mailing Address - Country:US
Mailing Address - Phone:315-331-7601
Mailing Address - Fax:
Practice Address - Street 1:439 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-2062
Practice Address - Country:US
Practice Address - Phone:315-332-3312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-15
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY475676-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse