Healthcare Provider Details

I. General information

NPI: 1013236157
Provider Name (Legal Business Name): EMILY KATHRYN MAROTTA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 05/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 ROCKINGHAM RD UNIT 2
WINDHAM NH
03087-1347
US

IV. Provider business mailing address

60 ROCKINGHAM RD UNIT 2
WINDHAM NH
03087-1347
US

V. Phone/Fax

Practice location:
  • Phone: 603-890-8541
  • Fax: 603-890-8736
Mailing address:
  • Phone: 603-890-8541
  • Fax: 603-890-8736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number3545
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: