Provider Demographics
NPI:1982924403
Name:LEKHRAJ B. KACHORIA MD PC
Entity Type:Organization
Organization Name:LEKHRAJ B. KACHORIA MD PC
Other - Org Name:PROFESSIONAL CORPORATION
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEKHRAJ
Authorized Official - Middle Name:B
Authorized Official - Last Name:KACHORIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-986-2100
Mailing Address - Street 1:1033 PITTSFORD-PALMYRA RD
Mailing Address - Street 2:
Mailing Address - City:MACEDON
Mailing Address - State:NY
Mailing Address - Zip Code:14502-8218
Mailing Address - Country:US
Mailing Address - Phone:315-986-2100
Mailing Address - Fax:315-986-0193
Practice Address - Street 1:1033 PITTSFORD-PALMYRA RD
Practice Address - Street 2:
Practice Address - City:MACEDON
Practice Address - State:NY
Practice Address - Zip Code:14502-8218
Practice Address - Country:US
Practice Address - Phone:315-986-2100
Practice Address - Fax:315-986-2100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125110207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00449587Medicaid
D78329Medicare UPIN
NY10120BMedicare PIN