Provider Demographics
NPI:1881729150
Name:ROTHMAN, STUART MARK (OD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:MARK
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 E NORTHFIELD RD
Mailing Address - Street 2:SUITE LL3
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4802
Mailing Address - Country:US
Mailing Address - Phone:973-992-0998
Mailing Address - Fax:973-992-8961
Practice Address - Street 1:349 E NORTHFIELD RD
Practice Address - Street 2:SUITE LL3
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4802
Practice Address - Country:US
Practice Address - Phone:973-992-0998
Practice Address - Fax:973-992-8961
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00419500152W00000X
NYT003783-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ557831Medicare ID - Type Unspecified
NJT10409Medicare UPIN