Healthcare Provider Details

I. General information

NPI: 1780503094
Provider Name (Legal Business Name): YASENIA BARROSO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1561 LONG POND RD STE 202
ROCHESTER NY
14626-4135
US

IV. Provider business mailing address

5 LACROIX COURT DR APT I
ROCHESTER NY
14609-1530
US

V. Phone/Fax

Practice location:
  • Phone: 585-922-8350
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360011-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: