Provider Demographics
NPI:1962737494
Name:ROTHMAN, LEONARD JULIAN (MD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JULIAN
Last Name:ROTHMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-2024
Mailing Address - Country:US
Mailing Address - Phone:845-534-8996
Mailing Address - Fax:
Practice Address - Street 1:77 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-2024
Practice Address - Country:US
Practice Address - Phone:845-534-8996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY095257-1207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology