Provider Demographics
NPI:1043259997
Name:SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK
Entity type:Organization
Organization Name:SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHS PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-862-1900
Mailing Address - Street 1:2157 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2648
Mailing Address - Country:US
Mailing Address - Phone:716-862-1000
Mailing Address - Fax:
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2648
Practice Address - Country:US
Practice Address - Phone:716-862-1450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401324N314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY93OtherINDEPENDENT HEATLH
NY105OtherHEALTHNOW
NY00011299001OtherUNIVERA HEALTHCARE
NY00346754Medicaid
NY335419Medicare ID - Type Unspecified
NY00011299001OtherUNIVERA HEALTHCARE