MEDICARE: MATTHEW J HAICK RN

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	849638	NY

General Provider Information

NPI Number	:	1831015684
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW J HAICK RN

Provider Business Mailing Address
First Line	:	4805 HERMITAGE RD
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1494
Country	:	US
Telephone Number	:	716-628-2841
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FOREST AVE
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14213-1207
Country	:	US
Telephone Number	:	716-885-2261
Fax Number	:

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

Provider Enumeration Date	:	06/25/2026
Last Update Date	:	06/25/2026

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