Provider Demographics
NPI:1942242706
Name:SISTERS OF CHARITY HOSPITAL
Entity Type:Organization
Organization Name:SISTERS OF CHARITY HOSPITAL
Other - Org Name:SISTERS OF CHARITY REHABILITATION UNIT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHS PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-862-1900
Mailing Address - Street 1:2157 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2648
Mailing Address - Country:US
Mailing Address - Phone:716-862-1000
Mailing Address - Fax:
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2648
Practice Address - Country:US
Practice Address - Phone:716-862-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SISTERS OF CHARITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-12
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1401013H273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00354563Medicaid
NY00354563Medicaid