Provider Demographics
NPI:1770867996
Name:ROTUNNO, LUANNE
Entity Type:Individual
Prefix:MRS
First Name:LUANNE
Middle Name:
Last Name:ROTUNNO
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 1:3343 SUMMERSET CT
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1277
Mailing Address - Country:US
Mailing Address - Phone:716-693-4103
Mailing Address - Fax:
Practice Address - Street 1:6839 ERRICK RD
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-1107
Practice Address - Country:US
Practice Address - Phone:716-215-3240
Practice Address - Fax:716-215-3260
Is Sole Proprietor?:No
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011565-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY011565-1OtherNEW YORK STATE LICENSE