Individual
MIKELLE DEMMERLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
210 E MAIN ST STE 301, SPRINGVILLE, NY 14141-1453
(716) 592-2832
Mailing address
210 E MAIN ST STE 301, SPRINGVILLE, NY 14141-1453
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
311324
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06585726
—
NY
Enumeration date
04/07/2018
Last updated
04/21/2025
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