JAY EDWARD ROTH

PHILADELPHIA, PA
NPI1851615066
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: PA  sp010741)
Enumeration Date2010-03-16
Last Update Date2010-03-16
Business Address
Mr. JAY EDWARD ROTH CRNP
706 S 11TH ST #3B
PHILADELPHIA, PA 19147-1968
Phone number: 215-913-7381
Mailing Address
Mr. JAY EDWARD ROTH CRNP
706 S 11TH ST #3B
PHILADELPHIA, PA 19147-1968
Phone number: 215-913-7381
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