Individual
CHERYL KODJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-2964
(585) 242-9733
Mailing address
601 ELMWOOD AVE, BOX 635, ROCHESTER, NY 14642-0001
(585) 275-2964
(585) 242-9733
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
206166
NY
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
206166
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02244177
—
NY
Enumeration date
06/12/2006
Last updated
07/05/2023
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