Provider Demographics
NPI:1154556744
Name:ROTELLI, CHERI ANN (MS, PT)
Entity type:Individual
Prefix:MRS
First Name:CHERI
Middle Name:ANN
Last Name:ROTELLI
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6296 FLY RD
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9333
Mailing Address - Country:US
Mailing Address - Phone:315-701-5710
Mailing Address - Fax:315-701-5711
Practice Address - Street 1:6296 FLY RD
Practice Address - Street 2:
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9333
Practice Address - Country:US
Practice Address - Phone:315-701-5710
Practice Address - Fax:315-701-5711
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009425-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist