Provider Demographics
NPI:1386678563
Name:BOGHANI, ASHISH B (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:B
Last Name:BOGHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:131 ROBY DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2113
Mailing Address - Country:US
Mailing Address - Phone:585-242-0124
Mailing Address - Fax:585-461-4941
Practice Address - Street 1:1000 SOUTH AVE
Practice Address - Street 2:HIGHLAND HOSPITAL
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-2733
Practice Address - Country:US
Practice Address - Phone:585-473-2200
Practice Address - Fax:585-341-8096
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207973208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01852262Medicaid
NY101725BJOtherPREFERRED CARE
NYP010207973OtherBLUE CHOICE
G31708Medicare UPIN