Provider Demographics
NPI:1992842082
Name:BUFFALO KIDNEY ASSOCIATES, LLP
Entity Type:Organization
Organization Name:BUFFALO KIDNEY ASSOCIATES, LLP
Other - Org Name:SALEEM A. KHAN, M.D. AND MOHAMAD SHAFI, M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:
Authorized Official - Last Name:AUSTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-835-8615
Mailing Address - Street 1:3435 BAILEY AVENUE- SOUTH BUILDING
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215
Mailing Address - Country:US
Mailing Address - Phone:716-835-8615
Mailing Address - Fax:716-835-1021
Practice Address - Street 1:3435 BAILEY AVENUE- SOUTH BUILDING
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215
Practice Address - Country:US
Practice Address - Phone:716-835-8615
Practice Address - Fax:716-835-1021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02671465Medicaid
NY00030832201OtherUNIVERA GROUP#
NY02671465Medicaid
NYBA0558Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER