MEDICARE: BENSON LOUIS ZOGHLIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	169892	NY
2	207Q00000X	Family Medicine Physician	169892	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0009148344001	OTHER	NY	HEALTHNOW
3	CFP1698927	OTHER	NY	WORKERS COMPENSATION
4	010169892	OTHER	NY	BLUE CHOICE
5	MD129D	OTHER	NY	PREFERRED CARE
6	7764326	OTHER	NY	AETNA
7	6950	OTHER	NY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1164489803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENSON LOUIS ZOGHLIN M.D.

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:	585-392-9100
Fax Number	:	585-392-6292

Provider Business Practice Location Address
First Line	:	279 EAST AVE
Second Line	:	HILTON HEALTH CARE, P.C.
City	:	HILTON
State	:	NY
Zip	:	14468-1333
Country	:	US
Telephone Number	:	585-392-9100
Fax Number	:	585-392-4020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	03/21/2023

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