person
Dr. Jerome M Privitera, DPM
Foot & Ankle Surgery Podiatrist in Mentor, Ohio
NPI 1639173628

Jerome M Privitera is a Foot & Ankle Surgery Podiatrist based in Mentor, OH and is specialized in Foot & Ankle Surgery. Jerome M Privitera practices in Mentor, OH and has the professional credentials of DPM. The NPI Number for Jerome M Privitera is 1639173628 and holds a License No. 002454 (Ohio).

The current practice location address for Jerome M Privitera is 9485 Mentor Ave, Mentor, OH and can be reached out via phone at 440-205-5878 and via fax at 440-205-5875.

Location: 9485 Mentor Ave, Mentor, OH, 44060-8723
person
Provider Profile Details
NPI Number
1639173628
Provider Name
Jerome M Privitera
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
9485 Mentor Ave, Mentor, OH, 44060-8723
Phone Number
440-205-5878
Fax Number
440-205-5875
Provider Enumeration Date
06/08/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0799202 05 OH
0791214 01 OH UNITED HEALTHCARE
000000242734 01 OH ANTHEM
institution
Provider Business Practice Location Address Details
Address
9485 Mentor Ave
City
State
Zip
44060-8723
Phone Number
440-205-5878
Fax Number
440-205-5875
person
Provider Business Mailing Address Details
Address
9485 Mentor Ave
City
State
Zip
44060-8723
Phone Number
440-205-5878
Fax Number
440-205-5875
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot & Ankle Surgery
Taxonomy
License No.
002454 (Ohio)
Definition
Definition to come...
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