Provider Demographics
NPI:1164478574
Name:DESMARAIS, MARGARET A (FNP)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:A
Last Name:DESMARAIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3117 MILITARY RD
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-4813
Mailing Address - Country:US
Mailing Address - Phone:716-257-1254
Mailing Address - Fax:716-215-6170
Practice Address - Street 1:3117 MILITARY RD
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-4813
Practice Address - Country:US
Practice Address - Phone:716-257-1254
Practice Address - Fax:716-215-6170
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333602363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02225354Medicaid
NY02225354Medicaid
P56825Medicare UPIN