Healthcare Provider Details

I. General information

NPI: 1730139536
Provider Name (Legal Business Name): KALEIDA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 ELLICOTT ST
BUFFALO NY
14203-1021
US

IV. Provider business mailing address

PO BOX 8000 DEPT. 413
BUFFALO NY
14267-0002
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-7200
  • Fax:
Mailing address:
  • Phone: 716-692-2160
  • Fax: 716-213-0348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ANGELA H MCCROREY
Title or Position: AR BILLING MANAGER
Credential:
Phone: 716-859-8313