Provider Demographics
NPI:1841976313
Name:ROTH, ESTHER GITTY
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:GITTY
Last Name:ROTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 QUICKWAY RD UNIT 305
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3872
Mailing Address - Country:US
Mailing Address - Phone:845-250-8686
Mailing Address - Fax:
Practice Address - Street 1:24 QUICKWAY RD UNIT 305
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3872
Practice Address - Country:US
Practice Address - Phone:845-250-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1-23-66085103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst