Provider Demographics
NPI:1871226027
Name:ROTH, JOHN JOSEPH (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JOSEPH
Last Name:ROTH
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:90 MATAWAN RD STE 302
Mailing Address - Street 2:
Mailing Address - City:MATAWAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07747-2653
Mailing Address - Country:US
Mailing Address - Phone:732-441-7177
Mailing Address - Fax:732-441-7165
Practice Address - Street 1:2501 KUSER RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-3386
Practice Address - Country:US
Practice Address - Phone:609-896-0444
Practice Address - Fax:609-587-4349
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2025-06-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MD00388200213E00000X, 213ES0103X
PASC007296213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist