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NPI Code Detail

MEDICARE: ST CATHERINE LABOURE MEDICAL ADULT DAY HEALTHCARE PROGRAM

MEDICARE: ST CATHERINE LABOURE MEDICAL ADULT DAY HEALTHCARE PROGRAM
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
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598751547
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST CATHERINE LABOURE MEDICAL ADULT DAY HEALTHCARE PROGRAM
Provider Business Mailing Address
First Line : 2157 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14214-2648
Country : US
Telephone Number : 716-862-1450
Fax Number :
Provider Business Practice Location Address
First Line : 2157 MAIN ST
Second Line :
City : BUFFALO
State : NY
Zip : 14214-2648
Country : US
Telephone Number : 716-862-1450
Fax Number :
Authorized Official
Title or Position : SR VP/CFO
Name : JAMES A DUNLOP JR.
Credential :
Telephone Number : 716-862-2431
Provider Enumeration Date : 09/26/2005
Last Update Date : 03/26/2010

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Directions to “ST CATHERINE LABOURE MEDICAL ADULT DAY HEALTHCARE PROGRAM ” Practice Location

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