Provider Demographics
NPI:1417628132
Name:MAROTTA, YOLANDA SUZANNE (LPN)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:SUZANNE
Last Name:MAROTTA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 CABOT RD
Mailing Address - Street 2:
Mailing Address - City:GREECE
Mailing Address - State:NY
Mailing Address - Zip Code:14626-2308
Mailing Address - Country:US
Mailing Address - Phone:585-200-6885
Mailing Address - Fax:
Practice Address - Street 1:75 CABOT RD
Practice Address - Street 2:
Practice Address - City:GREECE
Practice Address - State:NY
Practice Address - Zip Code:14626-2308
Practice Address - Country:US
Practice Address - Phone:585-200-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342282-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse