Roache, Edmund J
Roache, Edmund J is an individual health care provider with primary practice located at 200 Mullin St , Watertown NY 13601-3619. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Roache, Edmund J can be contacted via phone (315) 785-8591.Contact Information
Primary practice address
200 Mullin St
Watertown NY 13601-3619
Phone: (315) 785-8591
Fax: (315) 782-4475
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 153941 | New York |
Profile Details
| NPI number | 1780636704 |
|---|---|
| LBN Legal business name | Roache, Edmund J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Aug 3rd, 2015 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780636704 | NPPES |
| New York | MEDICAID | 00772743 |
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