Provider Demographics
NPI:1932110780
Name:ROTHBERG, PAUL G (PHD)
Entity Type:Individual
Prefix:PROF
First Name:PAUL
Middle Name:G
Last Name:ROTHBERG
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:UNIVERSITY OF ROCHESTER MEDICAL CENTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-273-2229
Mailing Address - Fax:585-273-5120
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:UNIVERSITY OF ROCHESTER MEDICAL CENTER
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-273-2229
Practice Address - Fax:585-273-5120
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYCQP26695 ROTHP1207SG0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics