Doctor Name: | MRS. REBECCA DOTTOLO |
NPI Number: | 1053672261 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 603366 |
Business Practice Address: | 510 S 4th St Fulton, NY - 130692904 |
Business Phone Number: | 3155923500 |
Business Fax Number: | |
Mailing Address: | 510 S 4th St, FULTON |
State: | NY |
Postal Code: | 130692904 |
Phone Number: | 3155923500 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2012 |
NPI Last Update Date: | 09/24/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 603366 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |