Provider Demographics
NPI:1770210940
Name:TROTTA, ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:TROTTA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1041 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-1230
Mailing Address - Country:US
Mailing Address - Phone:516-376-8243
Mailing Address - Fax:
Practice Address - Street 1:1670 EMPIRE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2119
Practice Address - Country:US
Practice Address - Phone:585-671-0850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-06
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist