Provider Demographics
NPI:1386187292
Name:DEMERIN, MICHELLE ANNE (PT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANNE
Last Name:DEMERIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BROADWAY
Mailing Address - Street 2:DOBBS FERRY. NEW YORK 10522
Mailing Address - City:DOBBS FERRY
Mailing Address - State:NY
Mailing Address - Zip Code:10522-2835
Mailing Address - Country:US
Mailing Address - Phone:914-693-6800
Mailing Address - Fax:
Practice Address - Street 1:115 BROADWAY
Practice Address - Street 2:DOBBS FERRY. NEW YORK 10522
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2835
Practice Address - Country:US
Practice Address - Phone:914-693-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-24
Last Update Date:2016-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY849935001225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist