Provider Demographics
NPI:1184716698
Name:FISCHETTO, ROBERT THOMAS (OD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:THOMAS
Last Name:FISCHETTO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:132 RUMFORD RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-5206
Mailing Address - Country:US
Mailing Address - Phone:585-723-0246
Mailing Address - Fax:585-663-5944
Practice Address - Street 1:3042 RIDGE RD W
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-1645
Practice Address - Country:US
Practice Address - Phone:585-663-6000
Practice Address - Fax:585-663-5944
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04574152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU79375Medicare UPIN