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General NPI Number Information
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NPI Number | 1326023953
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Entity Type | Individual
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Provider Name | KENTON E FORTE M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 03/02/2014
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Provider Practice Location Address
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Address Line | 964 DELAWARE AVE
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City | BUFFALO
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State | NY
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Zip | 14209-1806
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Country | US
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Telephone | 716-886-4202
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Fax | 716-884-9168
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Provider Business Mailing Address
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Address Line | 964 DELAWARE AVE
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City | BUFFALO
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State | NY
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Zip | 14209-1806
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Country | US
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Telephone | 716-886-4202
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Fax | 716-884-9168
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 1656651
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 165665
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License Number State | NY
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