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Jeanine Rotolo

Specialist

Other Service Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Jeanine Rotolo does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:04 PM.

Profile Details

Provider ID
1184979916
Provider Type
Individual
Full Name
Rotolo, Jeanine
Title
Ms.

Gender
Female
Sole Proprietor
No
Enumeration Date
7/18/2012
Last Updated
7/18/2012

Contact Information

Practice Location

228 Glensummer Rd, Holbrook, NY 11741

(631) 567-1528

Unlisted Fax

Mailing Location

228 Glen Summer Rd, Holbrook, NY 11741-5025

(631) 567-1528

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License Unlisted Issuer New York

Provider Identifiers

ID	Description	Issuer
ID 252YOOOOOX	Description Medicaid	Issuer Unlisted New York

Jeanine Rotolo

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Harris, Ada M

O Mahony, Karen Ann

Campagna, Elizabeth

Fiala, Robin J

Gunther, Karen M.

Montoya, Lynn Joan

Ryan, Kathleen Teresa

Mariano, Joy

Germain, Clara

Arthurs, Emily