Healthcare Provider Details

I. General information

NPI: 1396163747
Provider Name (Legal Business Name): ASHLEY PAIGE O'CONNELL FERSTER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY PAIGE O'CONNELL MD

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 07/03/2023
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 S CLINTON AVE STE 200
ROCHESTER NY
14618-2663
US

IV. Provider business mailing address

601 ELMWOOD AVE BOX 629
ROCHESTER NY
14642-0001
US

V. Phone/Fax

Practice location:
  • Phone: 585-758-5700
  • Fax: 585-758-1299
Mailing address:
  • Phone: 585-275-2901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number305723
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License Number305723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: