Lance Miguel Aris Demavivas Sares, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

049655 Issued in NY

Practice address

196 North St
Geneva, NY 14456-1651

Phone

(315) 787-4570

Fax

(315) 787-4573

NPI assigned

Jan 24, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1674518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1386350346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 NORTH ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561651",
            "telephone_number": "315-787-4570",
            "fax_number": "315-787-4573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 NORTH ST",
            "city": "GENEVA",
            "state": "NY",
            "postal_code": "144561651",
            "telephone_number": "315-787-4570",
            "fax_number": "315-787-4573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARES",
        "first_name": "LANCE MIGUEL ARIS",
        "middle_name": "DEMAVIVAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-24",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark S Ryan, M.D.
• Marc Sadovnic, MD
• Judith Ann Salotti, GNP
• Michael J Salotti, R.PH.
• Lisa Boccia Salter, LCSW
• Rachel Schiek
• Jacqueline Maria Schmit, MS CCC-SLP
• Maureen A Schuck, OTR/L
• Steven Andrew Schulz, MD
• Mary Katherine Schweitz, LMSW

• Physical Therapist in Geneva, NY
• Providers in Geneva, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.