Theodore Martin Roth, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

0074101 Issued in NY

Practice address

369 Ashford Avenue
Dobbs Ferry, NY 10522-2626

Phone

(914) 674-0573

Fax

(914) 631-4928

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427177211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 ASHFORD AVENUE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222626",
            "telephone_number": "914-674-0573",
            "fax_number": "914-631-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 ASHFORD AVENUE",
            "city": "DOBBS FERRY",
            "state": "NY",
            "postal_code": "105222626",
            "telephone_number": "914-674-0573",
            "fax_number": "914-631-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "THEODORE",
        "middle_name": "MARTIN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "0074101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0011039",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02035798",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P392307",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "065848",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noelle Roper
• Damaris Rosario
• Gregory Rosen
• Karen Beth Rosen, LCSW
• Nina F Ross, M.A., CCC-SLP
• Bert A Rothman, PSYD
• Lauren Michelle Ruiz
• Jessie Lee Rumpf, LCSW
• Nadia Rust
• Susan Rynn

• Psychologist in Dobbs Ferry, NY
• Providers in Dobbs Ferry, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.