Provider Demographics
NPI:1548293137
Name:ZHAVORONKOVA, MARGARITA (MD)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:ZHAVORONKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 WESTFALL RD
Mailing Address - Street 2:BLDG A
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2638
Mailing Address - Country:US
Mailing Address - Phone:585-368-4141
Mailing Address - Fax:
Practice Address - Street 1:919 WESTFALL RD
Practice Address - Street 2:BLDG A
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2638
Practice Address - Country:US
Practice Address - Phone:585-368-4141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214739207RS0012X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP00838560OtherMEDICARE RR
NY02119657Medicaid
NYJ400058457-GRPBA0017Medicare PIN
NYCC0629-GRP:70008AMedicare PIN
NYJ400058457-GRPBA0017Medicare PIN