Provider Demographics
NPI:1497339428
Name:ROTHSTEIN, MANDY-LEE (RPH)
Entity Type:Individual
Prefix:
First Name:MANDY-LEE
Middle Name:
Last Name:ROTHSTEIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 WINDFLOWER LN
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-4274
Mailing Address - Country:US
Mailing Address - Phone:215-901-1061
Mailing Address - Fax:
Practice Address - Street 1:8500 NEW FALLS RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-1636
Practice Address - Country:US
Practice Address - Phone:215-943-3694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-06
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040565R183500000X
NJ28R102159600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty