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NPI Code Detail

MEDICARE: SHOBHA BOGHANI M.D.

MEDICARE: SHOBHA BOGHANI 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
1207W00000XOphthalmology Physician218035NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1821023854
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHOBHA BOGHANI M.D.
Provider Business Mailing Address
First Line : 601 ELMWOOD AVE
Second Line : BOX 659
City : ROCHESTER
State : NY
Zip : 14642-0001
Country : US
Telephone Number : 585-273-3937
Fax Number : 585-276-0236
Provider Business Practice Location Address
First Line : 1455 E RIDGE RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14621-2006
Country : US
Telephone Number : 585-922-4315
Fax Number : 585-922-5741
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2006
Last Update Date : 07/05/2023

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