Provider Demographics
NPI:1376917435
Name:JAMES E. ROTOLO, M.D., F.A.C.S., P.A.
Entity Type:Organization
Organization Name:JAMES E. ROTOLO, M.D., F.A.C.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROTOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-903-7655
Mailing Address - Street 1:1696 ROUTE 88
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3030
Mailing Address - Country:US
Mailing Address - Phone:732-903-7655
Mailing Address - Fax:732-903-7622
Practice Address - Street 1:1696 ROUTE 88
Practice Address - Street 2:1ST FLOOR
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3030
Practice Address - Country:US
Practice Address - Phone:732-974-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05913400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty