Provider Demographics
NPI:1932139300
Name:JEWISH FAMILY SERVICE OF BUFFALO AND ERIE COUNTY
Entity Type:Organization
Organization Name:JEWISH FAMILY SERVICE OF BUFFALO AND ERIE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORT CARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-883-1914
Mailing Address - Street 1:70 BARKER ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209-2013
Mailing Address - Country:US
Mailing Address - Phone:716-883-1914
Mailing Address - Fax:716-883-7637
Practice Address - Street 1:70 BARKER ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-2013
Practice Address - Country:US
Practice Address - Phone:716-883-1914
Practice Address - Fax:716-883-1914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03B0358261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00688211Medicaid
NY00688211Medicaid