Provider Demographics
NPI:1518949379
Name:KUA, ALFREDO (MD)
Entity Type:Individual
Prefix:
First Name:ALFREDO
Middle Name:
Last Name:KUA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1848
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14240-1848
Mailing Address - Country:US
Mailing Address - Phone:716-923-4385
Mailing Address - Fax:716-246-4433
Practice Address - Street 1:2699 WEHRLE DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7332
Practice Address - Country:US
Practice Address - Phone:716-632-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2017-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205990207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010313402OtherUNIVERA
NY01592910Medicaid
NY0409868OtherIHA
NY000524962005OtherBC/BS
NY040511000329OtherFIDELIS
NY150966BJOtherPREFERRED CARE
G18521Medicare UPIN
NYDD3601Medicare PIN