Roth, Jessica R

Roth, Jessica R is an individual health care provider with primary practice located at 75 Bickford St , Jamaica Plain MA 02130-1401. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Roth, Jessica R can be contacted via phone (617) 971-2100.

Contact Information

Primary practice address
75 Bickford St Jamaica Plain MA 02130-1401
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 82155 Massachusetts

Profile Details

NPI number 1144392358
LBN Legal business name Roth, Jessica R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 14th, 2006
Last updated Jul 8th, 2007 - about 18 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 1144392358 NPPES
Massachusetts MEDICAID 3148080

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