Provider Demographics
NPI:1063703437
Name:ROTHBERG, NORIKO SAITO (NP)
Entity type:Individual
Prefix:
First Name:NORIKO
Middle Name:SAITO
Last Name:ROTHBERG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2975 ROSLYN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-3325
Mailing Address - Country:US
Mailing Address - Phone:303-399-7900
Mailing Address - Fax:303-399-7999
Practice Address - Street 1:2975 ROSLYN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3325
Practice Address - Country:US
Practice Address - Phone:303-399-7900
Practice Address - Fax:303-399-7999
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO128518364SP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPediatrics