Provider Demographics
NPI:1831412345
Name:ROTOLI, TANIA I (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:TANIA
Middle Name:
Last Name:ROTOLI
Suffix:I
Gender:F
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:467 HIGH MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-2603
Mailing Address - Country:US
Mailing Address - Phone:973-427-6300
Mailing Address - Fax:973-427-7579
Practice Address - Street 1:467 HIGH MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NORTH HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-2603
Practice Address - Country:US
Practice Address - Phone:973-427-6300
Practice Address - Fax:973-427-7579
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03013100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist