Provider Demographics
NPI:1205006137
Name:CONNORS, KEVIN RICHARD JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:RICHARD
Last Name:CONNORS
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:375 N FRENCH RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2009
Mailing Address - Country:US
Mailing Address - Phone:716-691-3000
Mailing Address - Fax:716-691-5448
Practice Address - Street 1:375 N FRENCH RD
Practice Address - Street 2:SUITE 108
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2009
Practice Address - Country:US
Practice Address - Phone:716-691-3000
Practice Address - Fax:716-691-5448
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY033248183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1982613428Medicare UPIN