Provider Demographics
NPI:1215558275
Name:ROTHROCK, BEATA (RRT,NPS)
Entity Type:Individual
Prefix:
First Name:BEATA
Middle Name:
Last Name:ROTHROCK
Suffix:
Gender:F
Credentials:RRT,NPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7397 CEDAR RD
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062-8935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7397 CEDAR RD
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-8935
Practice Address - Country:US
Practice Address - Phone:908-268-7803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAYM0118922279P3900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2279P3900XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredNeonatal/PediatricsGroup - Single Specialty