Kenyon, Mark Anthony

Kenyon, Mark Anthony is an individual health care provider with primary practice located at 818 Ellicott St , Buffalo NY 14203-1021. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine is his primary health care specialty. Kenyon, Mark Anthony can be contacted via phone (716) 323-0220.

Contact Information

Primary practice address
818 Ellicott St Buffalo NY 14203-1021
Phone: (716) 323-0220
Fax: (716) 323-0293
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 228634 New York
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 228634 New York

Profile Details

NPI number 1881652238
LBN Legal business name Kenyon, Mark Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Jan 13th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881652238 NPPES
Other 1292497 IHA
Other 040426003098 IHA
MEDICAID 100831371001 IHA
Other 00026380601 IHA
Other 000527294001 IHA
MEDICAID 02409052 IHA

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