Provider Demographics
NPI:1235368879
Name:ROTONDO, LOUIS A (MA)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:A
Last Name:ROTONDO
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 MORRISON AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10310-2835
Mailing Address - Country:US
Mailing Address - Phone:171-844-2364
Mailing Address - Fax:
Practice Address - Street 1:178 MORRISON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-2835
Practice Address - Country:US
Practice Address - Phone:171-844-2364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-03
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health