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General NPI Number Information
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NPI Number | 1578602439
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Entity Type | Individual
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Provider Name | PETER K NAVRATIL LCSW-R, CASAC
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Gender | Male
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 2300 EAST AVENUE # 3
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City | ROCHESTER
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State | NY
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Zip | 14610
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Country | US
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Telephone | 585-355-7418
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Fax | 585-456-0236
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Provider Business Mailing Address
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Address Line | 567 ONTARIO DR
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City | ONTARIO
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State | NY
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Zip | 14519-9344
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Country | US
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Telephone | 315-333-5291
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Fax | 315-333-5291
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 025071
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License Number State | NY
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