Healthcare Provider Details

I. General information

NPI: 1821164104
Provider Name (Legal Business Name): KALEIDA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HIGH ST
BUFFALO NY
14203-1126
US

IV. Provider business mailing address

2192 SAVANNAH LN
LEXINGTON KY
40513-1812
US

V. Phone/Fax

Practice location:
  • Phone: 716-859-2352
  • Fax:
Mailing address:
  • Phone: 419-902-2626
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number087769
License Number StateOH

VIII. Authorized Official

Name: DR. MARK LAFTAVI
Title or Position: CHIEF OF TRANSPLANTATION
Credential: MD
Phone: 716-859-2352