Healthcare Provider Details

I. General information

NPI: 1255360939
Provider Name (Legal Business Name): MICHELE LYNNE TELGA WHNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 E MAIN ST
BATAVIA NY
14020-2519
US

IV. Provider business mailing address

430 E MAIN ST
BATAVIA NY
14020-2519
US

V. Phone/Fax

Practice location:
  • Phone: 585-815-1860
  • Fax: 585-510-0709
Mailing address:
  • Phone: 585-343-1124
  • Fax: 585-343-9622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF420307
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: