Provider Demographics
NPI:1306029087
Name:WAIT, SARAH D (ATC, LAT)
Entity Type:Individual
Prefix:MISS
First Name:SARAH
Middle Name:D
Last Name:WAIT
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9726
Mailing Address - Country:US
Mailing Address - Phone:585-265-9152
Mailing Address - Fax:
Practice Address - Street 1:120 ERIE CANAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14626-4607
Practice Address - Country:US
Practice Address - Phone:585-225-6296
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011493-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist