Individual provider · Type 1 NPI
Jay Edward Roth, CRNP
Psychiatric/Mental Health Nurse Practitioner · Philadelphia, PA
NPI number
1851615066
Active
Practice location
706 S 11th St, #3B
Philadelphia, PA 19147-1968
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | SP010741 (PA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1851615066
Jay Edward Roth, CRNP's National Provider Identifier is 1851615066, issued on Mar 16, 2010. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 16, 2010.