Healthcare Provider Details

I. General information

NPI: 1447856364
Provider Name (Legal Business Name): EMILY SANBORN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMILY JOERG

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 ROUTE 52 STE 2
HOPEWELL JUNCTION NY
12533-3253
US

IV. Provider business mailing address

16 MAYBROOK RD STE K
CAMPBELL HALL NY
10916-2741
US

V. Phone/Fax

Practice location:
  • Phone: 845-592-4747
  • Fax:
Mailing address:
  • Phone: 845-636-4344
  • Fax: 845-636-4355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number046752
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: