Individual provider · Type 1 NPI

Igor Khodak, MD

Student in an Organized Health Care Education/Training Program · Rochester, NY

NPI number 1073963252 Active · reactivated Nov 4, 2020

Practice location

601 Elmwood Ave
Rochester, NY 14642-3957

Call (585) 275-2100 Map

Mailing address

400 Shady Run Ln Unit 416
Rochester, NY 14625-2357

Other practice locations

  • 259 1st St, Mineola, NY 11501-3957 · (516) 663-8443

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed
Neonatal-Perinatal Medicine Physician 2080N0001X300485 (NY)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1073963252

Igor Khodak, MD's National Provider Identifier is 1073963252, issued on Jun 17, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Rochester, NY. The record was last updated on Jul 3, 2023.