Individual ProviderKeri DemyanickLicensed Practical NurseNursing Service ProvidersPractice Address493 Lake Ave, Lancaster, NY 14086-9666(716) 400-1869PECOS EnrollmentBased on the most recent information from CMS, provider Keri Demyanick does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1861631152Provider TypeIndividualFull NameDemyanick, KeriGenderFemaleSole ProprietorNoEnumeration Date2/11/2009Last Updated2/11/2009Contact InformationPractice LocationPractice Address493 Lake Ave, Lancaster, NY 14086-9666Phone(716) 400-1869FaxUnlisted FaxMailing LocationMailing Address493 Lake Ave, Lancaster, NY 14086-9666Phone(716) 400-1869FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense291031-1New York