Provider Demographics
NPI:1700866498
Name:ROTHBART, GARY EMIL (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:EMIL
Last Name:ROTHBART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:210 WESTCHESTER AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10604-2901
Mailing Address - Country:US
Mailing Address - Phone:914-681-3146
Mailing Address - Fax:914-682-6403
Practice Address - Street 1:1 THEALL RD
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-1404
Practice Address - Country:US
Practice Address - Phone:914-848-8700
Practice Address - Fax:914-682-6403
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2013-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY197267207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY760341OtherBLUE CROSS PPO
NY5017215OtherAETNA NON HMO
NY01693434Medicaid
NY133884168OtherEMPIRE STATE PLAN (NYS)
CT110007658Medicare ID - Type Unspecified
NY5017215OtherAETNA NON HMO
NY133884168OtherEMPIRE STATE PLAN (NYS)