Provider Demographics
NPI:1285302315
Name:BIENKO, KEVIN FRANK (PHARMD)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:FRANK
Last Name:BIENKO
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 LOWELL RD
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-1204
Mailing Address - Country:US
Mailing Address - Phone:716-352-1872
Mailing Address - Fax:
Practice Address - Street 1:345 AMHERST ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-2809
Practice Address - Country:US
Practice Address - Phone:716-515-2190
Practice Address - Fax:715-515-2400
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068077183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist