Provider Demographics
NPI:1275520645
Name:ROTHMAN, STANLEY JESS (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:JESS
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 ELM HILL DR
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-1906
Mailing Address - Country:US
Mailing Address - Phone:914-422-2796
Mailing Address - Fax:914-422-2798
Practice Address - Street 1:2 ELM HILL DR
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-1906
Practice Address - Country:US
Practice Address - Phone:914-422-2796
Practice Address - Fax:914-422-2798
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2022-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1509902084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY76A261Medicare UPIN