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General NPI Number Information
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NPI Number | 1598198822
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Entity Type | Organization
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Legal Business Name | KALEIDA HEALTH
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 475 S TRANSIT ST
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City | LOCKPORT
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State | NY
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Zip | 14094-5562
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Country | US
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Telephone | 716-878-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 475 S TRANSIT ST
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City | LOCKPORT
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State | NY
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Zip | 14094-5562
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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 | NP
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Name | MS. MELISSA BURGIO
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Credential |
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Telephone | 716-445-6097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 421040
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License Number State | NY
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