Provider Demographics
NPI:1134522907
Name:ROTOLI, JULIE MARIE (MSPT)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MARIE
Last Name:ROTOLI
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ASHLAND OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-1665
Mailing Address - Country:US
Mailing Address - Phone:410-688-6277
Mailing Address - Fax:
Practice Address - Street 1:803 RIDGE RD
Practice Address - Street 2:#A
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2489
Practice Address - Country:US
Practice Address - Phone:585-347-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027396-12251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic