Provider Demographics
NPI:1023298585
Name:DR ALAN M ROTHFELD LLC
Entity type:Organization
Organization Name:DR ALAN M ROTHFELD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROTHFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:301-864-1441
Mailing Address - Street 1:1905 QUEENS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-3669
Mailing Address - Country:US
Mailing Address - Phone:301-864-1441
Mailing Address - Fax:
Practice Address - Street 1:1905 QUEENS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-3669
Practice Address - Country:US
Practice Address - Phone:301-864-1441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1037213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDG02207Medicare PIN
MDT91629Medicare UPIN
MD5648450001Medicare NSC