Provider Demographics
NPI:1306145370
Name:ROTHLAUF, ELIZABETH BRIDGET (NP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:BRIDGET
Last Name:ROTHLAUF
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Gender:F
Credentials:NP
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 3000
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6504
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-731-5210
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-427-1540
Practice Address - Fax:212-410-7196
Is Sole Proprietor?:No
Enumeration Date:2011-03-16
Last Update Date:2017-01-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF300992-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02502587Medicaid