Healthcare Provider Details

I. General information

NPI: 1205104197
Provider Name (Legal Business Name): SHAYNA TOKAR AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2011
Last Update Date: 12/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2365 S CLINTON AVE SUITE 200
ROCHESTER NY
14618-2663
US

IV. Provider business mailing address

458 WEIDEL RD
WEBSTER NY
14580-1220
US

V. Phone/Fax

Practice location:
  • Phone: 585-758-5700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number002357-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: