Provider Demographics
NPI:1851476741
Name:KALEIDA HEALTH
Entity type:Organization
Organization Name:KALEIDA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP REVENUE CYCLE OPERATIONS
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-859-8383
Mailing Address - Street 1:726 EXCHANGE ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14210-1484
Mailing Address - Country:US
Mailing Address - Phone:716-859-8396
Mailing Address - Fax:
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:PSYCHIATRIC UNIT
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-859-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KALEIDA HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-26
Last Update Date:2008-03-11
Deactivation Date:2007-06-11
Deactivation Code:
Reactivation Date:2007-07-05
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00361968Medicaid
NY33S005Medicare Oscar/Certification
NY7000AAMedicare PIN