Provider Demographics
NPI:1639201775
Name:ROTT, GITTA (OD)
Entity Type:Individual
Prefix:DR
First Name:GITTA
Middle Name:
Last Name:ROTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-6148
Mailing Address - Country:US
Mailing Address - Phone:212-794-4555
Mailing Address - Fax:212-472-8041
Practice Address - Street 1:55 E 66TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-6148
Practice Address - Country:US
Practice Address - Phone:212-794-4555
Practice Address - Fax:212-472-8041
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV005187-1152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4348495OtherAETNA
NYP1947781OtherOXFORD
NY9092452OtherPHCS
NY80314OtherUNICARE
NYC47811OtherBLUE CROSS BLUE SHIELD
NY1032297OtherUNITEDHEALTH
NY9092452OtherPHCS
NY4348495OtherAETNA
NY1032297OtherUNITEDHEALTH
NYC47811Medicare PIN