| Mark Anthony Kenyon, MD | |
|
818 Ellicott St, Buffalo, NY 14203-1021 | |
| (716) 323-0220 | |
| (716) 323-0293 |
| Full Name | Mark Anthony Kenyon |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Emergency Medicine |
| Location | 818 Ellicott St, Buffalo, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881652238 | NPI | - | NPPES |
| 1292497 | Other | IHA | |
| 040426003098 | Other | FIDELIS | |
| 100831371001 | Medicaid | PA | |
| 00026380601 | Other | UNIVERA | |
| 000527294001 | Other | BC/BS | |
| 02409052 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 228634 (New York) | Secondary |
| 2080P0204X | Pediatrics - Pediatric Emergency Medicine | 228634 (New York) | Primary |
| Entity Name | University At Buffalo Pediatric Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912928599 PECOS PAC ID: 1355235540 Enrollment ID: O20040210000076 |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Anthony Kenyon, MD 1001 Main St Fl 5, Buffalo, NY 14203-1009 Ph: (716) 323-0220 | Mark Anthony Kenyon, MD 818 Ellicott St, Buffalo, NY 14203-1021 Ph: (716) 323-0220 |
Dr. Lauren Davidson, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 219 Bryant St, Buffalo, NY 14222 Phone: 716-878-7355 | |
Dr. Mary Ellen Emborsky, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1001 Main St Fl 5, Buffalo, NY 14203 Phone: 716-323-0220 Fax: 716-323-0293 | |
Dr. Meghan E Jacobs, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1001 Main St Fl 5, Buffalo, NY 14203 Phone: 716-323-0225 Fax: 716-323-0499 | |
Dr. Mona Bonanno, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1001 Main St Fl 4, Buffalo, NY 14203 Phone: 716-323-0260 Fax: 716-323-0294 | |
Dr. Roger A Forden, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 341 Englewood Ave, Buffalo, NY 14223 Phone: 716-833-2333 Fax: 716-833-3972 | |
Dr. Jessica Aliotta Donhauser, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 818 Ellicott St, Buffalo, NY 14203 Phone: 716-323-2000 Fax: 716-323-0292 | |
Daryl Roy Ehlenfield, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 560 Franklin St, Buffalo, NY 14202 Phone: 716-332-4472 Fax: 716-332-4474 |