Provider Demographics
NPI:1881980621
Name:ROTHCHILD, PAUL (N/A)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:ROTHCHILD
Suffix:
Gender:
Credentials:N/A
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:NIEDZWIECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:171 WESTCHESTER WAY
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-8691
Mailing Address - Country:US
Mailing Address - Phone:626-372-0317
Mailing Address - Fax:269-231-4372
Practice Address - Street 1:131 COLUMBIA AVE E STE 211
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3761
Practice Address - Country:US
Practice Address - Phone:626-372-0317
Practice Address - Fax:269-231-4372
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI229N00000X
246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, Medical
No229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersAnaplastologist