Provider Demographics
NPI:1073550307
Name:MAROTTA, ROCCO F (MD)
Entity Type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:F
Last Name:MAROTTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 KEELER CT
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-1000
Mailing Address - Country:US
Mailing Address - Phone:732-828-0361
Mailing Address - Fax:732-828-2345
Practice Address - Street 1:9 KEELER CT
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-1000
Practice Address - Country:US
Practice Address - Phone:203-801-3456
Practice Address - Fax:203-972-1561
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035930174400000X
NY1679812084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY29F751Medicare ID - Type Unspecified
NYE17748Medicare UPIN
CT26003535Medicare PIN