National Provider Identifier
Jacob William Raifstanger, PHYSICIAN ASSISTANT
Jacob William Raifstanger, PHYSICIAN ASSISTANT is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant in Rochester, NY and a listed phone number of (585) 581-6790.
Profile Overview
- NPI
- 1679989479
- Provider Type
- Individual
- Primary Specialty
- Surgical Physician Assistant
- Enumeration Date
- July 01, 2014
- Last Updated
- January 11, 2023
Practice Location
- 2655 Ridgeway Ave Ste 460
- Rochester, NY 14626-4296
Phone: (585) 581-6790
Mailing Address
- 100 Kings Hwy S
- Rochester, NY 14617-5504
Specialties
- Surgical Physician Assistant (363AS0400X)
Endpoints
- Jacob.Raifstanger@rochesterregional.org
Direct Messaging Address | Rochester, NY 14626
Full Record
- NPI
- 1679989479
- Entity Type
- Individual
- Last Name
- Raifstanger
- First Name
- Jacob
- Middle Name
- William
- Credential
- PHYSICIAN ASSISTANT
- Mailing Street Address
- 100 Kings Hwy S
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-5504
- Mailing Country
- US
- Mailing Phone
- (585) 922-1900
- Practice Street Address
- 2655 Ridgeway Ave Ste 460
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14626-4296
- Practice Country
- US
- Practice Phone
- (585) 581-6790
- Practice Fax
- (585) 581-6793
- Enumeration Date
- July 01, 2014
- Last Updated
- January 11, 2023
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- January 11, 2023
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Surgical Physician Assistant (363AS0400X)
- Other Identifiers
- 03957908 (NY)