Doctor Name: | MICHELE LYNNE TELGA |
NPI Number: | 1255360939 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | WHNPC |
License Number: | F420307 |
Business Practice Address: | 6668 4th Section Road Brockport, NY - 14420 |
Business Phone Number: | 5856372670 |
Business Fax Number: | 5856373678 |
Mailing Address: | 6668 4th Section Road, BROCKPORT |
State: | NY |
Postal Code: | 14420 |
Phone Number: | 5856372670 |
Fax Number: | 5856373678 |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | F420307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |