Provider Demographics
NPI:1811930563
Name:ROTHMAN, RONNI H (CNM)
Entity type:Individual
Prefix:
First Name:RONNI
Middle Name:H
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
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Mailing Address - Street 1:716 CORNELIA PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19118-4109
Mailing Address - Country:US
Mailing Address - Phone:215-327-1547
Mailing Address - Fax:215-242-9130
Practice Address - Street 1:401 W GERMANTOWN PIKE
Practice Address - Street 2:
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4229
Practice Address - Country:US
Practice Address - Phone:484-441-3272
Practice Address - Fax:215-242-9130
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMW008480L367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0424385000OtherINDEPENDENCE BC
PA01675967Medicaid