Provider Demographics
NPI:1295402493
Name:PRITTS, ALEXANDREA DAVI (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:DAVI
Last Name:PRITTS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 KINGS HWY S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14617-5504
Mailing Address - Country:US
Mailing Address - Phone:585-723-7972
Mailing Address - Fax:585-723-3119
Practice Address - Street 1:2655 RIDGEWAY AVE STE 420
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4296
Practice Address - Country:US
Practice Address - Phone:585-723-7972
Practice Address - Fax:585-723-3119
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027280363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical