Provider Demographics
NPI:1760765259
Name:ESTHER T ROTH LLC.
Entity Type:Organization
Organization Name:ESTHER T ROTH LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:718-436-6038
Mailing Address - Street 1:641 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4909
Mailing Address - Country:US
Mailing Address - Phone:718-436-6038
Mailing Address - Fax:
Practice Address - Street 1:641 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-4909
Practice Address - Country:US
Practice Address - Phone:718-436-6038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019719252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency