Healthcare Provider Details

I. General information

NPI: 1861219792
Provider Name (Legal Business Name): KATHEIRNE MARIE KAHLER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE MARIE ZYGAJ RN, BSN

II. Dates (important events)

Enumeration Date: 09/23/2024
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 VIRGINIA ST
BUFFALO NY
14201-2023
US

IV. Provider business mailing address

414 VIRGINIA ST
BUFFALO NY
14201-2023
US

V. Phone/Fax

Practice location:
  • Phone: 716-427-4541
  • Fax: 716-436-5037
Mailing address:
  • Phone: 716-427-4541
  • Fax: 716-436-5037

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number762715
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WP1700X
TaxonomyPerinatal Registered Nurse
License Number762715
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number762715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: