Individual
MARK A ROTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1001 WATERMAN AVE, EAST PROVIDENCE, RI 02914-1314
(401) 434-1773
(401) 435-0500
Mailing address
105 NEWTOWN RD # A, SUITE 5, DANBURY, CT 06810-4194
(203) 739-0765
(203) 739-0792
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
007027
CT
225100000X
Physical Therapist
Primary
02006
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114979226
AETNA
CT
Enumeration date
05/19/2006
Last updated
07/21/2011
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