Healthcare Provider Details

I. General information

NPI: 1316358609
Provider Name (Legal Business Name): KAYLA JEAN GARCIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA JEAN WIESNER M.D.

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 BROADWAY ST
BUFFALO NY
14212-1460
US

IV. Provider business mailing address

2157 MAIN ST
BUFFALO NY
14214-2648
US

V. Phone/Fax

Practice location:
  • Phone: 716-529-3020
  • Fax: 716-881-6247
Mailing address:
  • Phone: 716-862-1000
  • Fax: 716-862-1899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number293419
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0078278
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: