Provider Demographics
NPI:1326195165
Name:B.J. ROTH & SONS, INC
Entity Type:Organization
Organization Name:B.J. ROTH & SONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEARING AID DISPENSER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:201-437-8900
Mailing Address - Street 1:555 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3829
Mailing Address - Country:US
Mailing Address - Phone:201-437-8900
Mailing Address - Fax:201-437-0108
Practice Address - Street 1:555 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3829
Practice Address - Country:US
Practice Address - Phone:201-437-8900
Practice Address - Fax:201-437-0108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00074800237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6853200OtherUNISYS ID NUMBER