Individual
KIMBERLY B PRISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4711 TRANSIT RD, LANCASTER, NY 14043-4888
(716) 668-5331
(716) 668-5370
Mailing address
4711 TRANSIT RD, LANCASTER, NY 14043-4888
(716) 668-5331
(716) 668-5370
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
209492
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020521904
UNIVERA
NY
05
—
00020521904
—
NY
01
—
000525567004
BC/BS
NY
01
—
040426001948
FIDELIS
NY
01
—
1210687
IHA
NY
01
—
146561DL
PREFERRED CARE
NY
Enumeration date
12/28/2005
Last updated
09/29/2022
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