Provider Demographics
NPI:1982955845
Name:ROTUNDO, ERICA (NP)
Entity Type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:
Last Name:ROTUNDO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:ERICA
Other - Middle Name:
Other - Last Name:TUGGEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:FOUNDERS 600
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 WOODS RD
Practice Address - Street 2:
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1530
Practice Address - Country:US
Practice Address - Phone:914-493-6616
Practice Address - Fax:914-493-5827
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2017-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN271845363LA2200X
NY306454363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health