Healthcare Provider Details

I. General information

NPI: 1285302315
Provider Name (Legal Business Name): KEVIN FRANK BIENKO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2021
Last Update Date: 09/02/2021
Certification Date: 09/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 AMHERST ST
BUFFALO NY
14207-2809
US

IV. Provider business mailing address

98 LOWELL RD
KENMORE NY
14217-1204
US

V. Phone/Fax

Practice location:
  • Phone: 716-515-2190
  • Fax: 715-515-2400
Mailing address:
  • Phone: 716-352-1872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number068077
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: