Basic Information
Provider Information
NPI: 1396073383
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROTHBAUM
FirstName: ESTHER
MiddleName: SHEINDEL
NamePrefix: MRS.
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 ROBERT PITT DR
Address2:  
City: MONSEY
State: NY
PostalCode: 109523333
CountryCode: US
TelephoneNumber: 8453526800
FaxNumber: 8453527293
Practice Location
Address1: 40 ROBERT PITT DR
Address2:  
City: MONSEY
State: NY
PostalCode: 10952
CountryCode: US
TelephoneNumber: 8453526800
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/02/2009
LastUpdateDate: 12/02/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X076399-1NYY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


Home