Healthcare Provider Details

I. General information

NPI: 1770496218
Provider Name (Legal Business Name): SARAH ANAIS GONCALVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 EMPIRE BLVD STE 1C
WEBSTER NY
14580-1935
US

IV. Provider business mailing address

1411 16TH AVE N
LAKE WORTH BEACH FL
33460-6415
US

V. Phone/Fax

Practice location:
  • Phone: 585-935-7144
  • Fax:
Mailing address:
  • Phone: 954-860-6616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: