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Individual

DR. LISA MARIE ROTELLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D. O.

Contact information

Practice address
110 DECKER DR STE 100, JOHNSTOWN, NY 12095-2157
(518) 762-6731
(518) 762-7135
Mailing address
99 E STATE ST, GLOVERSVILLE, NY 12078-1203
(518) 762-6731
(518) 762-7135

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
229169
NY
208000000X
Pediatrics Physician
DO-901
AL
208D00000X
General Practice Physician
229169
NY

Other

Enumeration date
07/14/2006
Last updated
03/29/2021
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