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General NPI Number Information
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NPI Number | 1356420798
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Entity Type | Individual
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Provider Name | JOHN ROCCO ROBILOTTO OD, PHD
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Gender | Male
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 04/24/2019
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Provider Practice Location Address
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Address Line | 133 E 54TH ST STE 200
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City | NEW YORK
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State | NY
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Zip | 10022-4538
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Country | US
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Telephone | 212-650-4888
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Fax |
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Provider Business Mailing Address
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Address Line | 17 BAYLIS CT
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City | TARRYTOWN
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State | NY
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Zip | 10591-3601
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Country | US
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Telephone | 646-820-0096
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 252
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV007040-1
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License Number State | NY
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