MEDICARE: NATIONAL KIDNEY FOUNDATION OF WESTERN NEW YORK

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	251V00000X	Voluntary or Charitable Agency

General Provider Information

NPI Number	:	1629242649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONAL KIDNEY FOUNDATION OF WESTERN NEW YORK

Provider Business Mailing Address
First Line	:	300 DELAWARE AVE
Second Line	:	SUITE 101
City	:	BUFFALO
State	:	NY
Zip	:	14202-1807
Country	:	US
Telephone Number	:	716-835-1323
Fax Number	:	716-835-2281

Provider Business Practice Location Address
First Line	:	300 DELAWARE AVE
Second Line	:	SUITE 101
City	:	BUFFALO
State	:	NY
Zip	:	14202-1807
Country	:	US
Telephone Number	:	716-835-1323
Fax Number	:	716-835-2281

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MS. ANNE KC MCCOOEY
Credential	:
Telephone Number	:	716-835-1323

Provider Enumeration Date	:	04/22/2008
Last Update Date	:	04/22/2008

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