J.b. Roth And Assoc. P.a. | |
2110 Priest Bridge Dr Ste 4 Crofton MD 21114-2472 | |
(443) 584-3808 | |
Not Available |
Full Name | J.b. Roth And Assoc. P.a. |
---|---|
Speciality | Psychologist |
Location | 2110 Priest Bridge Dr Ste 4, Crofton, Maryland |
Authorized Official Name and Position | Jacob B. Roth (PRESIDENT) |
Authorized Official Contact | 2406870857 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
J.b. Roth And Assoc. P.a. 111 Kent Oaks Mews Gaithersburg MD 20878-5672 Ph: (240) 687-0857 | J.b. Roth And Assoc. P.a. 2110 Priest Bridge Dr Ste 4 Crofton MD 21114-2472 Ph: (443) 584-3808 |
NPI Number | 1801838214 |
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Provider Enumeration Date | 06/11/2006 |
Last Update Date | 12/14/2020 |
Certification Date | 12/14/2020 |
Medicare PECOS PAC ID | 0446263396 |
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Medicare Enrollment ID | O20060720000092 |
Identifier | Type | State | Issuer |
---|---|---|---|
1801838214 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
Provider Name | Jacob B Roth |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1326080730 PECOS PAC ID: 2264445113 Enrollment ID: I20060720000095 |
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