Provider Demographics
NPI:1760866586
Name:CHILDREN'S HEALTH HOME OF WESTERN NEW YORK (CHHWNY)
Entity Type:Organization
Organization Name:CHILDREN'S HEALTH HOME OF WESTERN NEW YORK (CHHWNY)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLEGRA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAROS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:716-878-7551
Mailing Address - Street 1:219 BRYANT ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-2006
Mailing Address - Country:US
Mailing Address - Phone:716-878-7981
Mailing Address - Fax:716-878-1892
Practice Address - Street 1:219 BRYANT ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-2006
Practice Address - Country:US
Practice Address - Phone:716-878-7981
Practice Address - Fax:716-878-1892
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KALEIDA HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-10
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY251B00000X
282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren
No251B00000XAgenciesCase Management