Roth, Larry H

Roth, Larry H is an sole proprietor health care provider with primary practice located at 521 Mount Auburn St , Watertown MA 02472-4191. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Roth, Larry H can be contacted via phone (617) 923-4400.

Contact Information

Primary practice address
521 Mount Auburn St Watertown MA 02472-4191
Fax: (617) 926-4549
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 40273 Massachusetts

Profile Details

NPI number 1750448452
LBN Legal business name Roth, Larry H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 2nd, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750448452 NPPES
Massachusetts MEDICAID 2068672

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