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Individual

PETER KINKEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5 LIMESTONE DR, SUITE B, WILLIAMSVILLE, NY 14221-7178
(716) 632-9399
(716) 632-7742
Mailing address
908 NIAGARA FALLS BLVD, SUITE 208, NORTH TONAWANDA, NY 14120-2019
(716) 692-3302
(716) 692-4342

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
144507
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000525431011
BLUE SHIELD OF WESTERN NY
01
000525431012
BLUE SHIELD OF WESTERN NY
05
00903993
NY
01
050701000002
FIDELIS
01
1525351W
WORKERS COMPENSATION
NY
01
1605752
INDEPENDENT HEALTH
Enumeration date
04/10/2006
Last updated
10/24/2012
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