Healthcare Provider Details

I. General information

NPI: 1336629872
Provider Name (Legal Business Name): JENA SAPERE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 FISHER RD
ROCHESTER NY
14624-3444
US

IV. Provider business mailing address

PO BOX 664
MENDON NY
14506-0664
US

V. Phone/Fax

Practice location:
  • Phone: 585-247-0270
  • Fax: 585-247-0294
Mailing address:
  • Phone: 585-851-9987
  • Fax: 866-299-5675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: