Provider Demographics
NPI:1942727458
Name:ROTKO, CHRISTINE (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:
Last Name:ROTKO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:999 ORONOQUE LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1379
Mailing Address - Country:US
Mailing Address - Phone:203-870-2022
Mailing Address - Fax:203-386-1144
Practice Address - Street 1:999 ORONOQUE LN FL 1
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1379
Practice Address - Country:US
Practice Address - Phone:203-870-2022
Practice Address - Fax:203-386-1144
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4382225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist