person
Jacob William Raifstanger, PHYSICIANASSISTANT
Surgical Physician Assistant in Rochester, New York
NPI 1679989479

Jacob William Raifstanger is a Surgical Physician Assistant based in Rochester, NY and is specialized in Surgical. Jacob William Raifstanger practices in Rochester, NY and has the professional credentials of PHYSICIANASSISTANT. The NPI Number for Jacob William Raifstanger is 1679989479 and holds a License No. 017837 (New York).

The current practice location address for Jacob William Raifstanger is 2655 Ridgeway Ave Ste 460, Rochester, NY and can be reached out via phone at 585-581-6790 and via fax at 585-581-6793.

Location: 2655 Ridgeway Ave Ste 460, Rochester, NY, 14617-5504
person
Provider Profile Details
NPI Number
1679989479
Provider Name
Jacob William Raifstanger
Credential
PHYSICIANASSISTANT
Provider Entity Type
Individual
Gender
Male
Address
2655 Ridgeway Ave Ste 460, Rochester, NY, 14617-5504
Phone Number
585-581-6790
Fax Number
585-581-6793
Provider Enumeration Date
07/01/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
03957908 05 NY
institution
Provider Business Practice Location Address Details
Address
2655 Ridgeway Ave Ste 460
City
State
Zip
14626-4296
Phone Number
585-581-6790
Fax Number
585-581-6793
person
Provider Business Mailing Address Details
Address
2655 Ridgeway Ave Ste 460
City
State
Zip
14626-4296
Phone Number
585-581-6790
Fax Number
585-581-6793
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
017837 (New York)
Definition
Definition to come...
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