Privitera, Jerome M

Privitera, Jerome M is an individual health care provider with primary practice located at 9485 Mentor Ave Ste 200, Mentor OH 44060-8723. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Privitera, Jerome M can be contacted via phone (440) 205-5878.

Contact Information

Primary practice address
9485 Mentor Ave Ste 200 Mentor OH 44060-8723
Phone: (440) 205-5878
Fax: (440) 205-5875
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 002454 Ohio

Profile Details

NPI number 1639173628
LBN Legal business name Privitera, Jerome M
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2005
Last updated Jan 21st, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639173628 NPPES
Ohio MEDICAID 0799202
Ohio Other 0791214
Ohio Other 000000242734

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