Basic Information
| Provider Information | |||||||||
| NPI: | 1477987592 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBOTTI | ||||||||
| FirstName: | AMANDA | ||||||||
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| Credential: | P.T., D.P.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 162 E 78TH ST | ||||||||
| Address2: | FLOOR 5 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100750406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124399130 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1710 SUBURBAN AVE | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551066636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512543200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/26/2013 | ||||||||
| LastUpdateDate: | 11/13/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 036593 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.