Provider Demographics
NPI:1205858529
Name:PITTINARO, DEBORAH R (NP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:R
Last Name:PITTINARO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 685
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-1608
Mailing Address - Fax:585-242-8707
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0002
Practice Address - Country:US
Practice Address - Phone:585-275-1608
Practice Address - Fax:585-242-8707
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF420344363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYNP0322OtherPREFERRED CARE
NYP019420344OtherBLUE CHOICE
NY03074797Medicaid
NYJ400003868Medicare PIN
NY03074797Medicaid
NYJ400042907Medicare PIN