Kenmore Urgent Care PLLC

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

102346 Issued in NY

Legal business name

KENMORE URGENT CARE PLLC

Practice address

2949 Elmwood Ave
Suite 104
Kenmore, NY 14217-1356

Phone

(716) 876-7606

Fax

(716) 876-7608

NPI assigned

Sep 17, 2013

Last updated

Sep 18, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tarik Elibol, M.D.

Title

Ownerr

Phone

(716) 876-7606

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1033545454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2949 ELMWOOD AVE",
            "address_2": "SUITE 104",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171356",
            "telephone_number": "716-876-7606",
            "fax_number": "716-876-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2949 ELMWOOD AVE",
            "address_2": "SUITE 104",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171356",
            "telephone_number": "716-876-7606",
            "fax_number": "716-876-7608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENMORE URGENT CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "ELIBOL",
        "authorized_official_first_name": "TARIK",
        "authorized_official_title_or_position": "OWNERR",
        "authorized_official_telephone_number": "716-876-7606",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NY",
            "license": "102346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00647865",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenmore Mercy Hospital
• Kenmore Mercy Hospital (Kenmore Mercy Professional Services)
• Kenmore Mercy Hospital
• Kenmore Nuclear Medicine PC
• Kenmore Physicians Association, LLP
• Alison Kerling
• Nichole Kerner, PT, DPT
• Jonathan D Kessler, M.D.
• David Khatib, DO
• Angela Kilgore

• Urgent Care Clinic/Center in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Urgent Care Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.