MEDICARE: ROBERT ROTUNNO PHARM.D

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	183500000X	Pharmacist	065527	NY

General Provider Information

NPI Number	:	1588293450
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ROTUNNO PHARM.D

Provider Business Mailing Address
First Line	:	26 HERMAN AVE
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3406
Country	:	US
Telephone Number	:	631-988-2401
Fax Number	:

Provider Business Practice Location Address
First Line	:	26 HERMAN AVE
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3406
Country	:	US
Telephone Number	:	631-988-2401
Fax Number	:

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

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	04/03/2020

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