Provider Demographics
NPI:1568220002
Name:ROTHMAN, KALMAN D
Entity Type:Individual
Prefix:
First Name:KALMAN
Middle Name:D
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:KAL
Other - Middle Name:
Other - Last Name:ROTHMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 413
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-0413
Mailing Address - Country:US
Mailing Address - Phone:201-447-6020
Mailing Address - Fax:845-627-3220
Practice Address - Street 1:55 OLD TURNPIKE RD STE 106
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2449
Practice Address - Country:US
Practice Address - Phone:820-144-7602
Practice Address - Fax:845-627-3220
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025996183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist