JACOB WILLIAM RAIFSTANGER PHYSICIAN ASSISTANT NPI 1679989479

NPI Information

Jacob William Raifstanger, PHYSICIAN ASSISTANT is a surgical physician assistant in Rochester, NY with 10 years of experience. Jacob William Raifstanger, PHYSICIAN ASSISTANT NPI is 1679989479. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2655 RIDGEWAY AVE STE 460
ROCHESTER, NY
ZIP 14626-296
Phone: (585) 581-6790
Fax: (585) 581-6793

The NPI 1679989479 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/1/2014 and was last updated on 8/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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