Individual provider · Type 1 NPI

Jennifer D. Roth, PA

Physician Assistant · Glen Cove, NY

NPI number 1063636280 Active

Practice location

104 Forest Ave
Glen Cove, NY 11542-2015

Call (516) 759-5406 Map

Mailing address

4626 217th St
Bayside, NY 11361-3530

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	009096 (NY)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1063636280

Jennifer D. Roth, PA's National Provider Identifier is 1063636280, issued on Apr 11, 2007. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Glen Cove, NY. The record was last updated on Jul 8, 2007.