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DR. ZACHARY JOSEPH ROTH M.D. NPI 1194968016

NPI Profile

NPI: 1194968016

Provider Name: DR. ZACHARY JOSEPH ROTH, M.D.

Classification: Student in an Organized Health Care Education/Training Program - 390200000X

Entity Type: Individual

Organization: ROBERT E BRASS MD PLLC

PECOS Registration: Yes

Address:
713 TROY SCHENECTADY RD
SUITE 135
LATHAM, NY
ZIP 12110

Phone: (518) 782-7827

DR. Zachary Joseph Roth, M.D. is a student in an organized health care education/training program in Latham, NY with 6 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Zachary Joseph Roth, M.D. NPI is 1194968016. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2009

The provider's business location address is:

713 TROY SCHENECTADY RD
SUITE 135
LATHAM, NY
ZIP 12110-490
Phone: (518) 782-7827

The NPI 1194968016 is registered in the Medicare Provider, Enrollment, Chain and Ownership System PECOS.

The enumeration date for this NPI number is 4/7/2009 and was last updated on 4/30/2013.

Map - Location of Practice

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 390200000X Student in an Organized Health Care Education/Training Program 62884 NEW YORK Yes

What is NPI?
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 6/10/2015