MEDICARE: JADE KENDALL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	127294	NY

General Provider Information

NPI Number	:	1467294660
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JADE KENDALL

Provider Business Mailing Address
First Line	:	227 THORN AVE
Second Line	:
City	:	ORCHARD PARK
State	:	NY
Zip	:	14127-2600
Country	:	US
Telephone Number	:	716-662-2440
Fax Number	:	716-662-0019

Provider Business Practice Location Address
First Line	:	1775 NIAGARA ST
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14207-3110
Country	:	US
Telephone Number	:	716-828-0560
Fax Number	:	716-242-0158

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	04/21/2026

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Directions to “ JADE KENDALL ” Practice Location

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