Organization
KENNETH L. GAYLES, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH L GAYLES (PRESIDENT)
(716) 895-1100
Entity
Organization
Contact information
Practice address
840 HUMBOLDT PKWY, BUFFALO, NY 14211-1217
(716) 895-1100
(716) 895-8460
Mailing address
840 HUMBOLDT PKWY, BUFFALO, NY 14211-1217
(716) 895-1100
(716) 895-8460
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
124683
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010061001
UNIVERA
NY
01
—
000507349001
BC/BS WNY
NY
05
—
00608397
—
NY
01
—
0098639
GHI
NY
01
—
2100466
INDEPENDENT HEALTH
NY
Enumeration date
09/12/2007
Last updated
10/09/2012
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