Provider Demographics
NPI:1710476411
Name:PILLITTERE, JULIE
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:PILLITTERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 S CLINTON AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2668
Mailing Address - Country:US
Mailing Address - Phone:585-461-0520
Mailing Address - Fax:
Practice Address - Street 1:2400 S CLINTON AVE STE 110
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2668
Practice Address - Country:US
Practice Address - Phone:585-461-0520
Practice Address - Fax:585-461-4426
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311161207R00000X
NY31161-01207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine