MEDICARE: DR. JOHN ROCCO ROBILOTTO OD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	252	AK
2	152W00000X	Optometrist	TUV007040-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356420798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN ROCCO ROBILOTTO OD, PHD

Provider Business Mailing Address
First Line	:	17 BAYLIS CT
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-3601
Country	:	US
Telephone Number	:	646-820-0096
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 E 54TH ST STE 200
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10022-4538
Country	:	US
Telephone Number	:	212-650-4888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2006
Last Update Date	:	04/24/2019

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