Provider Demographics
NPI:1669828497
Name:ROTHSTEIN, KRYSTEN MARION (DO)
Entity Type:Individual
Prefix:DR
First Name:KRYSTEN
Middle Name:MARION
Last Name:ROTHSTEIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MRS
Other - First Name:KRYSTEN
Other - Middle Name:MARION
Other - Last Name:KOVACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-2200
Mailing Address - Fax:216-445-0605
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-2200
Practice Address - Fax:216-445-0605
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-11
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014693207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology