Healthcare Provider Details

I. General information

NPI: 1083677140
Provider Name (Legal Business Name): JEFFREY FICHTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 05/01/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 S CLINTON AVE
ROCHESTER NY
14618-2608
US

IV. Provider business mailing address

1820 S CLINTON AVE
ROCHESTER NY
14618-2608
US

V. Phone/Fax

Practice location:
  • Phone: 585-473-2846
  • Fax: 585-473-3098
Mailing address:
  • Phone: 585-473-2846
  • Fax: 585-473-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number154544-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: