Provider Demographics
NPI:1760175749
Name:PRIVITERA, ROBERT DONALD
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DONALD
Last Name:PRIVITERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 ALEXANDER ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1141
Mailing Address - Country:US
Mailing Address - Phone:716-909-0745
Mailing Address - Fax:
Practice Address - Street 1:150 MOUNT HOPE AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1016
Practice Address - Country:US
Practice Address - Phone:585-445-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor