Healthcare Provider Details

I. General information

NPI: 1962336388
Provider Name (Legal Business Name): JENNIFER M FERNAAYS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 ERIE CANAL DR STE 300
ROCHESTER NY
14626-4609
US

IV. Provider business mailing address

649 AUTUMN BREEZE LN
ONTARIO NY
14519-8712
US

V. Phone/Fax

Practice location:
  • Phone: 585-865-8210
  • Fax: 585-865-7597
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357991
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: