Provider Demographics
NPI:1326186842
Name:ROTHSTEIN, JUDITH S (L AC)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:S
Last Name:ROTHSTEIN
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10314 TAILCOAT WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3809
Mailing Address - Country:US
Mailing Address - Phone:410-740-3288
Mailing Address - Fax:410-992-7718
Practice Address - Street 1:8167 MAIN ST.
Practice Address - Street 2:STE.203
Practice Address - City:ELLICOTT CTIY
Practice Address - State:MD
Practice Address - Zip Code:21043-4776
Practice Address - Country:US
Practice Address - Phone:410-461-6543
Practice Address - Fax:410-992-7718
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD000353171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist