1972147551 NPI number — MRS. ANNE MARIE ROTCHFORD REGISTERED NURSE

Table of content: MRS. ANNE MARIE ROTCHFORD REGISTERED NURSE (NPI 1972147551)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972147551 NPI number — MRS. ANNE MARIE ROTCHFORD REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROTCHFORD
Provider First Name:
ANNE MARIE
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROTCHFORD
Provider Other First Name:
ANNE MARIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1972147551
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2400 HALSEY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10461-3646
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-430-0753
Provider Business Mailing Address Fax Number:
718-430-0739

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 HALSEY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461-3646
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-430-0753
Provider Business Practice Location Address Fax Number:
718-430-0739
Provider Enumeration Date:
11/06/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  538161 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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