MR. JAY EDWARD ROTH (NPI# 1851615066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851615066 |
| Entity Type | Individual |
| Full Name | MR. JAY EDWARD ROTH |
| Credential | CRNP |
| Practice Address |
706 S 11th St #3b Philadelphia PA 19147-1968 |
| Practice Telephone | 2159137381 |
| Mailing Telephone | 2159137381 |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
SP010741 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477900090 | Jay Roth | Social Worker | 200 E 115th St, Chicago, IL 60628-5015 | 2016-05-24 |
| 1932259041 | Jay C S Roth | Psychologist | 744 Mountain Blvd, Watchung, NJ 07069 | 2007-01-11 |
| Street Address |
706 S 11TH ST #3B |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19147-1968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508336181 | Jamica Cropper-pam | Counselor | 401 S 2nd St. Suite 301, Philadelphia, PA 19147 | 2018-11-27 |
| 1598234411 | Halina Dziewolska | Behavioral Analyst | 535 Queen Street, Philadelphia, PA 19147 | 2018-11-20 |
| 1972072908 | City Dental LLC | Clinic/Center | 1100 Washington Ave 2nd Floor, Philadelphia, PA 19147 | 2018-11-20 |
| 1487120218 | Christopher Michael Rosado | Behavioral Analyst | 1218-20 South 8th St, 1, Philadelphia, PA 19147 | 2018-10-19 |
| 1891271722 | Candice Millard | Dietitian, Registered | 419 S 8th St Apt 1b, Philadelphia, PA 19147 | 2018-07-13 |
| 1669998217 | Julianne Leonarda Wiebalk | Counselor | 814 South 4th Street, 1st Floor, Philadelphia, PA 19147 | 2017-08-16 |
| 1396269247 | Sara Parente | Social Worker | 1217 Fitzwater St., Unit A, Philadelphia, PA 19147 | 2017-08-02 |
| 1609398445 | Nikele Riek | Social Worker | 1348 Bainbridge Street, Philadelphia, PA 19147 | 2017-07-13 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1194196105 | Ann Courto | Dietitian, Registered | 1140 Cross Street, Philadelphia, PA 19147 | 2015-10-16 |
| Find all providers in zip 19147 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770199341 | Nicole Kassandra Carissimi | Nurse Practitioner | 1618 S 19th St, Philadelphia, PA 19145-1439 | 2020-09-19 |
| 1770192775 | Lisa Ghiloni | Nurse Practitioner | 6809 N 10th St, Philadelphia, PA 19126-2906 | 2020-07-26 |
| 1104440940 | Patricia Cecilia Castillo | Nurse Practitioner | 49204 Delaire Landing Rd, Philadelphia, PA 19114-5329 | 2020-06-06 |
| 1184271074 | Clement John | Nurse Practitioner | 3253 N 6th St, Philadelphia, PA 19140-5644 | 2019-08-25 |
| 1558915967 | Latoya Mohammed | Nurse Practitioner | 3300 Henry Ave Ste 3n, Philadelphia, PA 19129-1141 | 2019-07-25 |
| 1225427867 | Alison Ercole | Nurse Practitioner | 4301 Spruce St, Apt A 414, Philadelphia, PA 19104-4760 | 2015-01-20 |
| 1790195386 | Thomasean Britten | Nurse Practitioner | 449 Parker Ave, Philadelphia, PA 19128-4403 | 2014-05-05 |
| 1891048377 | Elizabeth Ann Milburn | Nurse Practitioner | 1528 Walnut St Ste 1414, Philadelphia, PA 19102-3610 | 2012-10-20 |
| 1336410851 | Justin Egoville | Nurse Practitioner | 80001 State Rd., Mhm Correctional Services, Mod II, Philadelphia, PA 19136-0000 | 2012-01-13 |
| 1396050720 | Dwayne M Toomer | Nurse Practitioner | 718 Addison St Apt E, Philadelphia, PA 19147-1353 | 2010-08-10 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19147 |
Please comment or provide details below to improve the information on MR. JAY EDWARD ROTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.