MEDICARE: ALISHA ANN PRIVITERA IBCLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174N00000X	Lactation Consultant (Non-RN)	L-319077	NY

General Provider Information

NPI Number	:	1770472599
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHA ANN PRIVITERA IBCLC

Provider Business Mailing Address
First Line	:	5300 PARTRIDGE HL
Second Line	:
City	:	GREAT VALLEY
State	:	NY
Zip	:	14741-9671
Country	:	US
Telephone Number	:	716-983-0797
Fax Number	:

Provider Business Practice Location Address
First Line	:	5300 PARTRIDGE HL
Second Line	:
City	:	GREAT VALLEY
State	:	NY
Zip	:	14741-9671
Country	:	US
Telephone Number	:	716-983-0797
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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Directions to “ ALISHA ANN PRIVITERA IBCLC” Practice Location

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