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General NPI Number Information
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NPI Number | 1538595939
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Entity Type | Organization
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Legal Business Name | VA OF WNY
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Dates
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Enumeration Date | 09/18/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 3495 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1129
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Country | US
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Telephone | 716-834-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 DELAWARE AVE APT 314
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City | BUFFALO
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State | NY
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Zip | 14209-1140
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Country | US
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Telephone | 716-931-4794
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Fax |
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Authorized Official
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Title or Position | RN, BEHAVIORAL HEALTH
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Name | MISS JENNIFER A. MCDONALD
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Credential | RN
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Telephone | 716-862-3131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 273R00000X
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License Number State | NY
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