Provider Demographics
NPI:1174529853
Name:ROTHSTEIN, ANGELA F (CNP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:F
Last Name:ROTHSTEIN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9059 SPRINGBORO PIKE
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4418
Mailing Address - Country:US
Mailing Address - Phone:937-275-8900
Mailing Address - Fax:937-276-0534
Practice Address - Street 1:5 W WENGER RD
Practice Address - Street 2:STE D
Practice Address - City:ENGLEWOOD
Practice Address - State:OH
Practice Address - Zip Code:45322-2723
Practice Address - Country:US
Practice Address - Phone:937-275-8900
Practice Address - Fax:937-276-0534
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-05631363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRONP17102Medicare ID - Type Unspecified