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Individual

DR. K KENT CHEVLI

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 200, CHEEKTOWAGA, NY 14225-2563
(716) 844-5600
(716) 844-5750

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
195675
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010029501
UNIVERA
NY
01
000523274005
BCBS OF WNY
NY
05
01482255
NY
01
040426000815
FIDELIS
NY
01
1000375
GHI
NY
01
1909181
INDEPENDENT HEALTH
NY
01
195675-4
WORKERS COMP
NY
Enumeration date
06/30/2005
Last updated
08/13/2015
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