Provider Demographics
NPI:1871864934
Name:ARONOW-ROTH, SHARI MICHELE (PA)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:MICHELE
Last Name:ARONOW-ROTH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312A COMMACK RD
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3440
Mailing Address - Country:US
Mailing Address - Phone:631-499-3232
Mailing Address - Fax:
Practice Address - Street 1:312A COMMACK RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3440
Practice Address - Country:US
Practice Address - Phone:631-499-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-21
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004275-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant