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NPI Code Detail

MEDICARE: KEVIN B. KULICK M.D.,P.C.

MEDICARE: KEVIN B. KULICK M.D.,P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician

General Provider Information

NPI Number : 1619935301
Entity Type Code : Organization
Provider Name (Legal Business Name) : KEVIN B. KULICK M.D.,P.C.
Provider Business Mailing Address
First Line : 3839 DELAWARE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14217-1040
Country : US
Telephone Number : 716-874-2134
Fax Number : 716-874-8023
Provider Business Practice Location Address
First Line : 3839 DELAWARE AVE
Second Line :
City : BUFFALO
State : NY
Zip : 14217-1040
Country : US
Telephone Number : 716-874-2134
Fax Number : 716-874-8023
Authorized Official
Title or Position : PHYSICIAN
Name : DR. KEVIN BRADLEY KULICK
Credential : M.D.
Telephone Number : 716-874-2134
Provider Enumeration Date : 05/02/2006
Last Update Date : 08/22/2020

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