Healthcare Provider Details

I. General information

NPI: 1346853595
Provider Name (Legal Business Name): JOE FINGLER ATC, CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2020
Last Update Date: 08/27/2020
Certification Date: 08/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 WESTSIDE DR
ROCHESTER NY
14624-1997
US

IV. Provider business mailing address

2301 WESTSIDE DR
ROCHESTER NY
14624-1997
US

V. Phone/Fax

Practice location:
  • Phone: 585-594-6566
  • Fax:
Mailing address:
  • Phone: 585-594-6566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number001483-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: