Healthcare Provider Details

I. General information

NPI: 1225304561
Provider Name (Legal Business Name): JENNIFER FICHTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 PORTLAND AVE
ROCHESTER NY
14621-3011
US

IV. Provider business mailing address

12 SHADOW CRK
PENFIELD NY
14526-1062
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-4159
  • Fax: 585-922-3731
Mailing address:
  • Phone: 585-752-5134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number2018-01605
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number282195
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: