Provider Demographics
NPI:1477635308
Name:KALEIDA HEALTH
Entity Type:Organization
Organization Name:KALEIDA HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PNP
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GOLUBSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-743-9877
Mailing Address - Street 1:7220 SHAWNEE RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-1353
Mailing Address - Country:US
Mailing Address - Phone:716-856-2425
Mailing Address - Fax:
Practice Address - Street 1:295 CARLTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14204-1126
Practice Address - Country:US
Practice Address - Phone:716-856-2425
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3810571261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center