Healthcare Provider Details

I. General information

NPI: 1568090660
Provider Name (Legal Business Name): SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2157 MAIN ST
BUFFALO NY
14214-2648
US

IV. Provider business mailing address

144 GENESEE ST FL 3
BUFFALO NY
14203-1560
US

V. Phone/Fax

Practice location:
  • Phone: 716-862-1000
  • Fax:
Mailing address:
  • Phone: 716-601-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0404X
TaxonomyCardiac Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID P MACHOLZ
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 716-601-3690