National Provider Identifier

Kenneth Fan, DO

Kenneth Fan, DO is listed in the NPPES registry with a primary specialty of Obstetrics & Gynecology Physician in Buffalo, NY and a listed phone number of (716) 878-7750.

NPI 1801206750Buffalo, NYObstetrics & Gynecology Physician

Profile Overview

NPI
1801206750
Provider Type
Individual
Primary Specialty
Obstetrics & Gynecology Physician
Enumeration Date
April 30, 2014
Last Updated
June 28, 2018

Practice Location

  • 219 Bryant St
  • University At Buffalo Department Of Ob/Gyn
  • Buffalo, NY 14222

Phone: (716) 878-7750

Mailing Address

  • 405 Admirals Walk
  • Buffalo, NY 14202-4333

Specialties

  • Obstetrics & Gynecology Physician (207V00000X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1801206750
Entity Type
Individual
Last Name
Fan
First Name
Kenneth
Credential
DO
Mailing Street Address
405 Admirals Walk
Mailing City
Buffalo
Mailing State
NY
Mailing ZIP Code
14202-4333
Mailing Country
US
Mailing Phone
(626) 841-8082
Practice Street Address
219 Bryant St
Practice Address Line 2
University At Buffalo Department Of Ob/Gyn
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14222
Practice Country
US
Practice Phone
(716) 878-7750
Practice Fax
(716) 888-3833
Enumeration Date
April 30, 2014
Last Updated
June 28, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Obstetrics & Gynecology Physician (207V00000X), Student in an Organized Health Care Education/Training Program (390200000X)