Provider Demographics
NPI:1841669702
Name:RORDAM, BETH (DAC, OMD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:
Last Name:RORDAM
Suffix:
Gender:F
Credentials:DAC, OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E MAIN ST STE 204
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-2321
Mailing Address - Country:US
Mailing Address - Phone:914-924-3371
Mailing Address - Fax:
Practice Address - Street 1:125 E MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-2321
Practice Address - Country:US
Practice Address - Phone:914-924-3371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-22
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026169225700000X
NY005643171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist