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General NPI Number Information
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NPI Number | 1104028984
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Entity Type | Organization
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Legal Business Name | KALEIDA
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 80 GOODRICH ST
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City | BUFFALO
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State | NY
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Zip | 14203-1005
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Country | US
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Telephone | 716-859-1540
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Fax |
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Provider Business Mailing Address
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Address Line | 3292 UPPER MOUNTAIN RD
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City | SANBORN
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State | NY
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Zip | 14132-9104
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | JAMES KASKIE
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Credential |
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Telephone | 716-859-2732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 070685
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License Number State | NY
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