Provider Demographics
NPI:1447368543
Name:ROTHSTEIN, ROBERT (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:ROTHSTEIN
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 1:10814 72ND AVE
Mailing Address - Street 2:2ND FLR
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5350
Mailing Address - Country:US
Mailing Address - Phone:718-261-2727
Mailing Address - Fax:718-261-5302
Practice Address - Street 1:10814 72ND AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5350
Practice Address - Country:US
Practice Address - Phone:718-261-2727
Practice Address - Fax:718-261-5302
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205751207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01997828Medicaid
NY01997828Medicaid
NYG59518Medicare UPIN