Provider Demographics
NPI: | 1871355818 |
---|---|
Name: | MARC ROTHMAN MD PLLC |
Entity type: | Organization |
Organization Name: | MARC ROTHMAN MD PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MARC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | ROTHMAN |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 415-205-1229 |
Mailing Address - Street 1: | 85 DELANCEY ST |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10002-3182 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 415-205-1229 |
Mailing Address - Fax: | 888-299-5773 |
Practice Address - Street 1: | 28 LIBERTY ST |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10005-1400 |
Practice Address - Country: | US |
Practice Address - Phone: | 415-205-1229 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-01-25 |
Last Update Date: | 2025-05-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty |