Healthcare Provider Details

I. General information

NPI: 1275458341
Provider Name (Legal Business Name): MICHAELA KATHLEEN NIEDERMEIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

162 MAIN ST
HAMBURG NY
14075-4917
US

IV. Provider business mailing address

4855 SHIRLEY RD
NORTH COLLINS NY
14111-9786
US

V. Phone/Fax

Practice location:
  • Phone: 877-246-2396
  • Fax:
Mailing address:
  • Phone: 716-622-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: