Provider Demographics
NPI:1568218576
Name:ROTONDARO, AMANDA (ABA SPECIALIST)
Entity type:Individual
Prefix:MISS
First Name:AMANDA
Middle Name:
Last Name:ROTONDARO
Suffix:
Gender:F
Credentials:ABA SPECIALIST
Other - Prefix:MISS
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:ROTONDARO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ABA SPECIALIST
Mailing Address - Street 1:7 TORREY PINE LN
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-5864
Mailing Address - Country:US
Mailing Address - Phone:845-750-5064
Mailing Address - Fax:
Practice Address - Street 1:7 TORREY PINE LN
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-5864
Practice Address - Country:US
Practice Address - Phone:845-750-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty