Individual
KEVIN J BARLOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3085 HARLEM RD, STE 200, CHEEKTOWAGA, NY 14225-2563
(716) 844-5000
(716) 844-5050
Mailing address
3085 HARLEM RD, SUITE 350, CHEEKTOWAGA, NY 14225-2591
(716) 844-5600
(716) 844-5750
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
168798
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020002801
UNIVERA
NY
01
—
000504322002
BCBS OF WNY
NY
05
—
01018015
—
NY
01
—
040426001755
FIDELIS
NY
01
—
168798-7
WORKERS COMP
NY
01
—
1902078
INDEPENDENT HEALTH
NY
Enumeration date
06/30/2005
Last updated
08/13/2015
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