Roth, Mariam
Roth, Mariam is an individual health care provider with primary practice located at 250 Delaware Ave Suite 100, Delmar NY 12054-1420. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Roth, Mariam can be contacted via phone (518) 439-8077.Contact Information
Primary practice address
250 Delaware Ave Suite 100
Delmar NY 12054-1420
Phone: (518) 439-8077
Fax: (519) 439-8070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 271074 | New York |
Profile Details
| NPI number | 1700103819 |
|---|---|
| LBN Legal business name | Roth, Mariam |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2010 |
| Last updated | Feb 18th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700103819 | NPPES |
| New York | MEDICAID | 03636995 |
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