Healthcare Provider Details

I. General information

NPI: 1366489221
Provider Name (Legal Business Name): KALEIDA HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 TREMONT ST
NORTH TONAWANDA NY
14120-6150
US

IV. Provider business mailing address

726 EXCHANGE ST SUITE 300
BUFFALO NY
14210-1484
US

V. Phone/Fax

Practice location:
  • Phone: 716-690-2077
  • Fax:
Mailing address:
  • Phone: 716-859-7200
  • Fax: 716-859-8658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

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