Provider Demographics
NPI:1639632904
Name:ROTONDI, ROGER A JR (ATC)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:A
Last Name:ROTONDI
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 W CURTIS ST
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-5772
Mailing Address - Country:US
Mailing Address - Phone:908-486-7085
Mailing Address - Fax:
Practice Address - Street 1:700 W CURTIS ST
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-5772
Practice Address - Country:US
Practice Address - Phone:908-486-7085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer