Healthcare Provider Details

I. General information

NPI: 1205952801
Provider Name (Legal Business Name): JULIETTA FISCELLA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/05/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 SOUTH AVENUE BOX 20
ROCHESTER NY
14620
US

IV. Provider business mailing address

1000 SOUTH AVENUE BOX 20
ROCHESTER NY
14620
US

V. Phone/Fax

Practice location:
  • Phone: 585-341-8075
  • Fax: 585-341-8267
Mailing address:
  • Phone: 585-341-8075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number185562
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number185562
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: