MEDICARE: BUFFALO KIDNEY ASSOCIATES, LLP

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	207RN0300X	Nephrology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00030832201	OTHER	NY	UNIVERA GROUP#

General Provider Information

NPI Number	:	1992842082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUFFALO KIDNEY ASSOCIATES, LLP

Provider Business Mailing Address
First Line	:	3435 BAILEY AVENUE- SOUTH BUILDING
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215
Country	:	US
Telephone Number	:	716-835-8615
Fax Number	:	716-835-1021

Provider Business Practice Location Address
First Line	:	3435 BAILEY AVENUE- SOUTH BUILDING
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14215
Country	:	US
Telephone Number	:	716-835-8615
Fax Number	:	716-835-1021

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JODI AUSTIN
Credential	:
Telephone Number	:	716-835-8615

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/22/2020

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