National Provider Identifier

Ethan Young

Ethan Young is listed in the NPPES registry with a primary specialty of Physical Therapy Assistant in Rochester, NY and a listed phone number of (585) 924-4000.

NPI 1891583720Rochester, NYPhysical Therapy Assistant

Profile Overview

NPI
1891583720
Provider Type
Individual
Primary Specialty
Physical Therapy Assistant
Enumeration Date
April 29, 2025
Last Updated
April 29, 2025

Practice Location

  • 1425 Portland Ave
  • Rochester, NY 14621-3011

Phone: (585) 924-4000

Mailing Address

  • 6703 Dugway RD
  • Conesus, NY 14435-9542

Specialties

  • Physical Therapy Assistant (225200000X)
Full Record
NPI
1891583720
Entity Type
Individual
Last Name
Young
First Name
Ethan
Mailing Street Address
6703 Dugway RD
Mailing City
Conesus
Mailing State
NY
Mailing ZIP Code
14435-9542
Mailing Country
US
Mailing Phone
(585) 350-6963
Practice Street Address
1425 Portland Ave
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-3011
Practice Country
US
Practice Phone
(585) 924-4000
Enumeration Date
April 29, 2025
Last Updated
April 29, 2025
Sex
Male
Sole Proprietor
No
Certification Date
April 29, 2025
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapy Assistant (225200000X)