Healthcare Provider Details

I. General information

NPI: 1013029495
Provider Name (Legal Business Name): ROSE-MARIE FAOTTO PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL KLINGENSTEIN CARE CENTER, 2ND FLOOR
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

333 E 93RD ST APT 3B
NEW YORK NY
10128-5503
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-9186
  • Fax:
Mailing address:
  • Phone: 212-241-9186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number8505
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: