Individual
DR. KENNETH L GAYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
840 HUMBOLDT PKWY, BUFFALO, NY 14211-1217
(716) 895-1100
(716) 895-7615
Mailing address
840 HUMBOLDT PKWY, BUFFALO, NY 14211-1217
(716) 895-1100
(716) 895-7615
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
124683
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010104240
FIDELIS
NY
01
—
00010061001
UNIVERA HEALTHCARE
NY
01
—
000507349001
BC/BS OF WNY
NY
05
—
00608397
—
NY
01
—
0098639
GHI
NY
01
—
2100466
INDEPENDENT HEALTH
NY
Enumeration date
07/01/2006
Last updated
07/08/2007
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