Provider Demographics
NPI:1609658285
Name:ROTONDO, RITA
Entity Type:Individual
Prefix:
First Name:RITA
Middle Name:
Last Name:ROTONDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3867 CHARTER CLUB DRIVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18902
Mailing Address - Country:US
Mailing Address - Phone:267-240-0691
Mailing Address - Fax:
Practice Address - Street 1:3867 CHARTER CLUB DRIVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902
Practice Address - Country:US
Practice Address - Phone:267-240-0691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT012291L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist