Provider Demographics
NPI:1801932769
Name:NARENDRA C. CHANGKAKOTI
Entity type:Organization
Organization Name:NARENDRA C. CHANGKAKOTI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE
Authorized Official - Prefix:
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHANGKAKOTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:585-467-4700
Mailing Address - Street 1:1404 PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14621-3016
Mailing Address - Country:US
Mailing Address - Phone:585-467-4700
Mailing Address - Fax:585-544-2806
Practice Address - Street 1:1404 PORTLAND AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14621-3016
Practice Address - Country:US
Practice Address - Phone:585-467-4700
Practice Address - Fax:585-544-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty