Provider Demographics
NPI:1912391269
Name:FISHMAN, ROTH, CHASE, LLP
Entity Type:Organization
Organization Name:FISHMAN, ROTH, CHASE, LLP
Other - Org Name:SMILESNY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:ROTH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:212-752-6537
Mailing Address - Street 1:220 E 63RD ST
Mailing Address - Street 2:LOBBY FG
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7660
Mailing Address - Country:US
Mailing Address - Phone:212-752-6537
Mailing Address - Fax:
Practice Address - Street 1:220 E 63RD ST
Practice Address - Street 2:LOBBY FG
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7660
Practice Address - Country:US
Practice Address - Phone:212-752-6537
Practice Address - Fax:212-421-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039905261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental