Provider Demographics
NPI:1982072393
Name:ROTHMAN, YEHUDIT PEREL (PA)
Entity Type:Individual
Prefix:MRS
First Name:YEHUDIT
Middle Name:PEREL
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 LAUREL HILL TER
Mailing Address - Street 2:APT 4B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-4608
Mailing Address - Country:US
Mailing Address - Phone:201-881-9097
Mailing Address - Fax:
Practice Address - Street 1:142 LAUREL HILL TER
Practice Address - Street 2:APT 4B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-4608
Practice Address - Country:US
Practice Address - Phone:201-881-9097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AM0700X
OH50006279RX363A00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology