Jennifer Lynne Rottas, RN
Individual provider Active NPI Registered Nurse · Old Bethpage, NY
NPI 1457093759 · NPPES record last updated Apr 8, 2022
Key facts
- NPI
- 1457093759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 466617-1 (NY)
- Practice address
- 20 Lenmore Dr
Old Bethpage, NY 11804-1119 - Phone
- (516) 459-1437
- NPI assigned
- Apr 8, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 466617-1 | NY | MD | Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 466617-1 | NY | Yes |
Addresses
Primary practice location
20 Lenmore Dr
Old Bethpage, NY 11804-1119
Mailing address
20 Lenmore Dr
Old Bethpage, NY 11804-1119
Phone (516) 459-1437
Other providers in Old Bethpage, NY
- Progressive Applied Behavior Analysis PLLC
- Meredith Tracy Radisch
- Lena M Rapisarda
- Rides Unlimited of New York
- Camille Ann Roldan
- Andrew Paul Rubin
- Aviva E Sala
- Jill Schecter
- Lisa Schrank
- Emily Rebecca Schrier
All providers in Old Bethpage, NY · Registered Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.