Individual
KEVIN PRANIKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
462 GRIDER STREET, SUITE 119, BUFFALO, NY 14215
(716) 898-5008
(716) 898-4186
Mailing address
462 GRIDER STREET, SUITE 119, BUFFALO, NY 14215
(716) 898-5008
(716) 898-4186
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
124932
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010140903
BUFFALO COMMUNITY HEALTH
—
01
—
000507827003
CB COMMUNITY CARE FAMILY
—
01
—
0010640
GHI
—
01
—
00631434
GOLD CHOICE MCD
—
05
—
00631434
—
NY
01
—
1900822
IHA ENCOMPASS 65
—
Enumeration date
03/31/2006
Last updated
06/18/2012
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