Individual provider · Type 1 NPI

Jacob William Raifstanger, PHYSICIAN ASSISTANT

Surgical Physician Assistant · Rochester, NY

NPI number 1679989479 Active

Practice location

2655 Ridgeway Ave Ste 460
Rochester, NY 14626-4296

Call (585) 581-6790 Map

Fax (585) 581-6793

Mailing address

100 Kings Hwy S
Rochester, NY 14617-5504

Other practice locations

  • 1425 Portland Ave, Rochester, NY 14621-3001 · (585) 922-3458

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X017837 (NY)

Surgical Physician Assistant: Definition to come...

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About NPI 1679989479

Jacob William Raifstanger, PHYSICIAN ASSISTANT's National Provider Identifier is 1679989479, issued on Jul 1, 2014. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Rochester, NY. The record was last updated on Jan 11, 2023.