Provider Demographics
NPI:1871588756
Name:ROTHSTEIN, STEVEN A (DPM)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:A
Last Name:ROTHSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 BICENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-1306
Mailing Address - Country:US
Mailing Address - Phone:603-641-3668
Mailing Address - Fax:
Practice Address - Street 1:384 WILSON ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-4912
Practice Address - Country:US
Practice Address - Phone:603-641-8637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2007-11-21
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
NH159213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30363701Medicaid
NH4933760001Medicare NSC
NH30363701Medicaid
NHRE8170Medicare PIN