Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 274222 | NY |
N | 2084N0400X | Neurologist | 274222 | NY |
Y | 2084N0402X | Child Neurologist | 274222 | NY |
NPI | 1093009680 |
---|---|
Provider Name | Dr. Khalid Salem Kakish |
First Address | Williamsville, NY 14221-5799 |
Second Address | Buffalo, NY 14221-8208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2011 |
Last Update Date | 09/11/2016 |