MEDICARE: KALEIDA HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility
2	311ZA0620X	Adult Care Home Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366489221
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KALEIDA HEALTH

Provider Business Mailing Address
First Line	:	726 EXCHANGE ST
Second Line	:	SUITE 300
City	:	BUFFALO
State	:	NY
Zip	:	14210-1484
Country	:	US
Telephone Number	:	716-859-7200
Fax Number	:	716-859-8658

Provider Business Practice Location Address
First Line	:	445 TREMONT ST
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-6150
Country	:	US
Telephone Number	:	716-690-2077
Fax Number	:

Authorized Official
Title or Position	:	AR MANAGER
Name	:	ANGELA H MCCROREY
Credential	:
Telephone Number	:	716-859-8313

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	08/22/2024

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Directions to “KALEIDA HEALTH ” Practice Location

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