Raifstanger, Jacob William

Raifstanger, Jacob William is an individual health care provider with primary practice located at 2655 Ridgeway Ave Ste 460 , Rochester NY 14626-4296. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Raifstanger, Jacob William can be contacted via phone (585) 581-6790.

Contact Information

Primary practice address
2655 Ridgeway Ave Ste 460 Rochester NY 14626-4296
Phone: (585) 581-6790
Fax: (585) 581-6793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 017837 New York

Profile Details

NPI number 1679989479
LBN Legal business name Raifstanger, Jacob William
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2014
Last updated Jan 11th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679989479 NPPES
New York MEDICAID 03957908

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