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General NPI Number Information
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NPI Number | 1821202441
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Entity Type | Individual
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Provider Name | NATAN KHISHCHENKO MD
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Gender | Male
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2101 LAC DEVILLE BLVD. SUITE 1
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-546-3265
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Fax | 585-232-5158
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Provider Business Mailing Address
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Address Line | 2101 LAC DEVILLE BLVD. SUITE 1
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-546-3265
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Fax | 585-232-5158
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 90972
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 20726
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 245745
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License Number State | NY
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