Provider Demographics
NPI:1508388588
Name:DEMARCO, ERIN I
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:I
Last Name:DEMARCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 TENTH STREET
Mailing Address - Street 2:HODGE BUILDING
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301
Mailing Address - Country:US
Mailing Address - Phone:716-278-4747
Mailing Address - Fax:
Practice Address - Street 1:621 TENTH STREET
Practice Address - Street 2:HODGE BUILDING
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301
Practice Address - Country:US
Practice Address - Phone:716-278-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily