| Doctor Name: | MARK A ROTELLA |
| NPI Number: | 1104870773 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 007027 |
| Business Practice Address: | 1001 Waterman Ave East Providence, RI - 029141314 |
| Business Phone Number: | 4014341773 |
| Business Fax Number: | 4014350500 |
| Mailing Address: | 105 Newtown Rd # A, Suite 5 DANBURY |
| State: | CT |
| Postal Code: | 068104194 |
| Phone Number: | 2037390765 |
| Fax Number: | 2037390792 |
| NPI Enumeration Date: | 05/19/2006 |
| NPI Last Update Date: | 07/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 007027 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |