Healthcare Provider Details

I. General information

NPI: 1336052554
Provider Name (Legal Business Name): EMILY SARA YANCONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 WINTON RD S
ROCHESTER NY
14618-3998
US

IV. Provider business mailing address

2021 WINTON RD S
ROCHESTER NY
14618-3998
US

V. Phone/Fax

Practice location:
  • Phone: 585-427-7760
  • Fax: 585-341-2412
Mailing address:
  • Phone: 585-427-7760
  • Fax: 585-341-2412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number028114-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: