National Provider Identifier
Igor Khodak, M.D.
Igor Khodak, M.D. is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 275-2100.
Profile Overview
- NPI
- 1073963252
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- June 17, 2016
- Last Updated
- July 03, 2023
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-3957
Phone: (585) 275-2100
Mailing Address
- 400 Shady Run Ln Unit 416
- Rochester, NY 14625-2357
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
- Neonatal-Perinatal Medicine Physician (2080N0001X)
Endpoints
- ikhodak182651@direct.urmc.rochester.edu
Direct Messaging Address | Direct | Other | Rochester, NY 14642
Full Record
- NPI
- 1073963252
- Entity Type
- Individual
- Last Name
- Khodak
- First Name
- Igor
- Credential
- M.D.
- Mailing Street Address
- 400 Shady Run Ln Unit 416
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14625-2357
- Mailing Country
- US
- Mailing Phone
- (718) 578-8540
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-3957
- Practice Country
- US
- Practice Phone
- (585) 275-2100
- Enumeration Date
- June 17, 2016
- Last Updated
- July 03, 2023
- Deactivation Date
- June 17, 2019
- Reactivation Date
- November 04, 2020
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- November 09, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X), Neonatal-Perinatal Medicine Physician (2080N0001X)