MEDICARE: LAUREN ZOGHLIN

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	363AS0400X	Surgical Physician Assistant	317170	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2084N0400X	Neurology Physician	317170	NY

General Provider Information

NPI Number	:	1942798913
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ZOGHLIN

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE BOX 278984
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-4238
Country	:	US
Telephone Number	:	585-275-7854
Fax Number	:

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

Provider Enumeration Date	:	04/25/2018
Last Update Date	:	08/05/2025

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Directions to “ LAUREN ZOGHLIN ” Practice Location

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