Healthcare Provider Details

I. General information

NPI: 1487697058
Provider Name (Legal Business Name): WATERFRONT HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 7TH ST
BUFFALO NY
14201-2161
US

IV. Provider business mailing address

200 7TH ST
BUFFALO NY
14201-2161
US

V. Phone/Fax

Practice location:
  • Phone: 716-847-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY A BAGAROZZI
Title or Position: LONG TERM CARE MANAGER
Credential:
Phone: 716-859-8397