National Provider Identifier
Meghedy Shanazarian Khodak, MD
Meghedy Shanazarian Khodak, MD is listed in the NPPES registry with a primary specialty of Pediatrics Physician in Rochester, NY and a listed phone number of (585) 266-0310.
Profile Overview
- NPI
- 1215462122
- Provider Type
- Individual
- Primary Specialty
- Pediatrics Physician
- Enumeration Date
- April 28, 2017
- Last Updated
- August 13, 2020
Practice Location
- 809 East Ridge Road
- Rochester, NY 14621
Phone: (585) 266-0310
Specialties
- Pediatrics Physician (208000000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1215462122
- Entity Type
- Individual
- Last Name
- Khodak
- First Name
- Meghedy
- Middle Name
- Shanazarian
- Name Prefix
- Dr.
- Credential
- MD
- Provider Other Last Name
- Shanazarian
- Provider Other First Name
- Meghedy
- Provider Other Name Prefix Text
- Dr.
- Provider Other Credential Text
- M.D
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 809 East Ridge Road
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14621
- Mailing Country
- US
- Mailing Phone
- (585) 266-0310
- Mailing Fax
- (585) 266-9207
- Practice Street Address
- 809 East Ridge Road
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14621
- Practice Country
- US
- Practice Phone
- (585) 266-0310
- Practice Fax
- (585) 266-9207
- Enumeration Date
- April 28, 2017
- Last Updated
- August 13, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 2
- 193400000X Single Specialty Group
- Certification Date
- August 13, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatrics Physician (208000000X), Student in an Organized Health Care Education/Training Program (390200000X)