Provider Demographics
NPI:1528795978
Name:NEIGHBORHOOD HEALTH CENTER OF WNY, INC.
Entity type:Organization
Organization Name:NEIGHBORHOOD HEALTH CENTER OF WNY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAEFNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-875-2904
Mailing Address - Street 1:1569 NIAGARA STREET
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1469
Mailing Address - Country:US
Mailing Address - Phone:716-427-8000
Mailing Address - Fax:716-229-4552
Practice Address - Street 1:1569 NIAGARA STREET
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1469
Practice Address - Country:US
Practice Address - Phone:716-427-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-05
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07485830Medicaid