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General NPI Number Information
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NPI Number | 1437584109
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Entity Type | Individual
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Provider Name | AMANDA LYNN ROTONDO PT, DPT
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Gender | Female
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 10 WOODBRIDGE CENTER DR. SUITE 102
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City | WOODBRIDGE
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State | NJ
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Zip | 07095
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Country | US
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Telephone | 732-855-0380
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Fax | 732-855-0384
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Provider Business Mailing Address
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Address Line | 348 CRYSTAL AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10314-2007
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Country | US
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Telephone | 917-991-2709
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01511000
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 036831
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License Number State | NY
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