Individual
ANGELA ROTELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
211 J.B. WISE PLAZA, WATERTOWN, NY 13601
(315) 782-7445
(315) 779-1184
Mailing address
PO BOX 6550, WATERTOWN, NY 13601-6550
(315) 782-7445
(315) 779-1184
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
327890
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3372621
—
NY
Enumeration date
08/07/2018
Last updated
09/17/2020
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