Individual
DR. KENNETH G VANDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 MARTIN ST, WELLSVILLE, NY 14895-1057
(585) 593-6041
(585) 593-4919
Mailing address
12 MARTIN ST, WELLSVILLE, NY 14895-1057
(585) 593-6041
(585) 593-4919
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
100546
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00468048
—
NY
Enumeration date
08/23/2006
Last updated
07/08/2007
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