Provider Demographics
NPI:1881101954
Name:WESTERN NEW YORK INTEGRATED CARE COLLABORATIVE, INC.
Entity type:Organization
Organization Name:WESTERN NEW YORK INTEGRATED CARE COLLABORATIVE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BATTAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-532-1020
Mailing Address - Street 1:742 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14209
Mailing Address - Country:US
Mailing Address - Phone:716-887-2749
Mailing Address - Fax:
Practice Address - Street 1:742 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209
Practice Address - Country:US
Practice Address - Phone:716-887-2749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Single Specialty