Provider Demographics
NPI:1447241088
Name:HOSPICE BUFFALO, INC.
Entity Type:Organization
Organization Name:HOSPICE BUFFALO, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LEHSTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-989-2066
Mailing Address - Street 1:225 COMO PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14227-1416
Mailing Address - Country:US
Mailing Address - Phone:716-686-1900
Mailing Address - Fax:716-686-8181
Practice Address - Street 1:225 COMO PARK BLVD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-1416
Practice Address - Country:US
Practice Address - Phone:716-686-1900
Practice Address - Fax:716-686-8181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1455501F251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00955720Medicaid
NY00955720Medicaid