Healthcare Provider Details

I. General information

NPI: 1699726711
Provider Name (Legal Business Name): ROBERT LOUIS PITARO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

293 ROUTE 100 SUITE 104
SOMERS NY
10589-3213
US

IV. Provider business mailing address

1 WITTMANN DR
KATONAH NY
10536-3013
US

V. Phone/Fax

Practice location:
  • Phone: 914-277-3360
  • Fax: 914-277-1813
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number178474
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: