Healthcare Provider Details

I. General information

NPI: 1043394745
Provider Name (Legal Business Name): MOUNT ST. MARY'S HOSPITAL OF NIAGARA FALLS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 MILITARY RD
LEWISTON NY
14092-1903
US

IV. Provider business mailing address

5300 MILITARY RD
LEWISTON NY
14092-1903
US

V. Phone/Fax

Practice location:
  • Phone: 716-298-2081
  • Fax: 716-298-2112
Mailing address:
  • Phone: 716-298-2081
  • Fax: 716-298-2112

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 Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number3121001H
License Number StateNY

VIII. Authorized Official

Name: DAVID P MACHOLZ
Title or Position: CFO
Credential:
Phone: 716-862-2430