Provider Demographics
NPI:1043455199
Name:SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK
Entity type:Organization
Organization Name:SISTERS OF CHARITY HOSPITAL OF BUFFALO NEW YORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:MACHOLZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-862-2430
Mailing Address - Street 1:2157 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2648
Mailing Address - Country:US
Mailing Address - Phone:716-862-1000
Mailing Address - Fax:
Practice Address - Street 1:2605 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4018
Practice Address - Country:US
Practice Address - Phone:716-891-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-03
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0404X
NY1401013H282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
No261QR0404XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Cardiac Facilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY24OtherIHA
NY0000000005000OtherBLUE CROSS HEALTH NOW
NY0011413501OtherUNIVERA
NY040401000066OtherFIDELIS
NY330078Medicaid
NY0011413501OtherUNIVERA
NY330078Medicare UPIN