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NPI Code Detail

MEDICARE: EMILY LYNN JENNINGS

MEDICARE: EMILY LYNN JENNINGS
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
1225XP0200XPediatric Occupational Therapist028376NY

General Provider Information

NPI Number : 1417631953
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMILY LYNN JENNINGS
Provider Business Mailing Address
First Line : 204 N MAIN ST APT 201
Second Line :
City : WAYLAND
State : NY
Zip : 14572-1049
Country : US
Telephone Number : 315-329-1375
Fax Number :
Provider Business Practice Location Address
First Line : 2099 W RIDGE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-2728
Country : US
Telephone Number : 607-235-3980
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2023
Last Update Date : 03/22/2024

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