Provider Demographics
NPI:1659759470
Name:BUFFALO PSYCHIATRIC CENTER
Entity Type:Organization
Organization Name:BUFFALO PSYCHIATRIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER: LMSW-2
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DOROSZCZUK
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:716-532-2231
Mailing Address - Street 1:PO BOX 389
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:NY
Mailing Address - Zip Code:14034-0389
Mailing Address - Country:US
Mailing Address - Phone:716-532-2231
Mailing Address - Fax:716-532-2200
Practice Address - Street 1:72 MIDDLE ROAD
Practice Address - Street 2:
Practice Address - City:COLLINS
Practice Address - State:NY
Practice Address - Zip Code:14034-0389
Practice Address - Country:US
Practice Address - Phone:716-532-2231
Practice Address - Fax:716-532-2200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077034283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital