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Organization
KIDNEY AND HYPERTENSION PHYSICIAN PC
Active
Organization
KIDNEY AND HYPERTENSION PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASHANT PENDYALA MD (PRESIDENT)
(716) 650-0373
Entity
Organization
Contact information
Practice address
670 DAVISON RD, LOCKPORT, NY 14094-5338
(716) 650-0373
Mailing address
49 BRANTLEY CT, GETZVILLE, NY 14068-1547
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
241265
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02212706
—
NY
Enumeration date
08/16/2010
Last updated
08/16/2010
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