Provider Demographics
NPI:1336172980
Name:CHODROFF, MARCI J (MD)
Entity type:Individual
Prefix:
First Name:MARCI
Middle Name:J
Last Name:CHODROFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:919 WESTFALL RD
Mailing Address - Street 2:BLDG. B, SUITE 110
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618
Mailing Address - Country:US
Mailing Address - Phone:585-442-5150
Mailing Address - Fax:585-442-5152
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG. B, SUITE 110
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618
Practice Address - Country:US
Practice Address - Phone:585-442-5150
Practice Address - Fax:585-442-5152
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY197727-1207R00000X, 208M00000X
NY197727207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYRA5983Medicare PIN
NYRB4800Medicare PIN
NYRA5983Medicare UPIN