Groth, Maritza Lastra

Groth, Maritza Lastra is an individual health care provider with primary practice located at 70 N Country Rd Suite 101, Port Jefferson NY 11777-2161. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Groth, Maritza Lastra can be contacted via phone (631) 473-0037.

Contact Information

Primary practice address
70 N Country Rd Suite 101 Port Jefferson NY 11777-2161
Phone: (631) 473-0037
Fax: (631) 473-0228
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 159478 New York
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 159478 New York
Allopathic & Osteopathic Physicians / Sleep Medicine 207RS0012X 159478 New York

Profile Details

NPI number 1306908314
LBN Legal business name Groth, Maritza Lastra
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2006
Last updated Feb 14th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306908314 NPPES
New York MEDICAID 01211009

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