Healthcare Provider Details

I. General information

NPI: 1881410959
Provider Name (Legal Business Name): SARAH DAVIS 0TD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2024
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LYELL AVE STE 102
ROCHESTER NY
14606-5743
US

IV. Provider business mailing address

3895 WESTSIDE DR
CHURCHVILLE NY
14428-9775
US

V. Phone/Fax

Practice location:
  • Phone: 585-563-6060
  • Fax:
Mailing address:
  • Phone: 585-953-8109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number029581
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: