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General NPI Number Information
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NPI Number | 1811423890
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Entity Type | Individual
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Provider Name | ROBERT DANIEL PRANAAT
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Gender | Male
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 07/17/2023
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Provider Practice Location Address
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Address Line | 601 ELMWOOD AVE
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-1385
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Fax |
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Provider Business Mailing Address
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Address Line | 5615 N BURRAGE AVE
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City | PORTLAND
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State | OR
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Zip | 97217-4131
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Country | US
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Telephone | 503-928-0045
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Fax |
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 317153
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 317153
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License Number State | NY
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