MEDICARE: AUTUMN HOGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	464618	NY

General Provider Information

NPI Number	:	1063232288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUTUMN HOGAN

Provider Business Mailing Address
First Line	:	155 CANAL LANDING BLVD APT 733
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14626-5118
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6745 PITTSFORD PALMYRA RD
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-3343
Country	:	US
Telephone Number	:	585-223-3633
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/14/2024
Last Update Date	:	10/14/2024

Similar Medicare Providers

1356348874 — CREST MANOR LIVING AND REHABILITATION CENTER INC
Practice Location Address:

6745 PITTSFORD PALMYRA RD
FAIRPORT, NY
14450-3343

Practice Phone: 585-223-3633
Practice Fax: 585-425-2961

1144848409 — KELSY ALLESSI OTR
Practice Location Address:

6745 PITTSFORD PALMYRA RD
FAIRPORT, NY
14450-3343

Practice Phone: 585-223-3633
Practice Fax:

1811766496 — CREST OPCO LLC
Practice Location Address:

6745 PITTSFORD PALMYRA RD
FAIRPORT, NY
14450-3343

Practice Phone: 585-223-3633
Practice Fax:

1861347239 — KARLEE KESSELRING
Practice Location Address:

100 CROSSING CREEK DR
FAIRPORT, NY
14450-9614

Practice Phone: 585-472-6861
Practice Fax:

1982559456 — GRETCHEN VOLK MD PLLC
Practice Location Address:

6687 PITTSFORD PALMYRA RD
FAIRPORT, NY
14450-3403

Practice Phone: 585-678-8080
Practice Fax:

1053267963 — ANNA MELFI
Practice Location Address:

41 OCONNOR RD
FAIRPORT, NY
14450-1327

Practice Phone: 585-377-4660
Practice Fax:

Directions to “ AUTUMN HOGAN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.