Provider Demographics
NPI:1154614204
Name:FERAGOTTI, ROBERT D
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:D
Last Name:FERAGOTTI
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 1:3501 FORBES AVE FL 3
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3317
Mailing Address - Country:US
Mailing Address - Phone:412-246-5670
Mailing Address - Fax:412-246-5640
Practice Address - Street 1:3501 FORBES AVE FL 3
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3317
Practice Address - Country:US
Practice Address - Phone:412-246-5670
Practice Address - Fax:412-246-5640
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005877101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional