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NPI Code Detail

MEDICARE: OBIAMAKA CHIEGBOROM MD

MEDICARE:   OBIAMAKA  CHIEGBOROM  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician291752NY
2390200000XStudent in an Organized Health Care Education/Training ProgramNY
32084P0800XPsychiatry Physician291752-1NY

General Provider Information

NPI Number : 1366849093
Entity Type Code : Individual
Provider Name (Legal Business Name) : OBIAMAKA CHIEGBOROM MD
Provider Business Mailing Address
First Line : 197 HALF HOLLOW RD
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-5859
Country : US
Telephone Number : 631-370-1713
Fax Number :
Provider Business Practice Location Address
First Line : 197 HALF HOLLOW RD
Second Line :
City : DIX HILLS
State : NY
Zip : 11746-5859
Country : US
Telephone Number : 631-370-1845
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2014
Last Update Date : 09/08/2022

Similar Medicare Providers

1811829211 — MARIA CHIECO
Practice Location Address:
197 HALF HOLLOW RD
DIX HILLS, NY
11746-5859
Practice Phone: 631-370-1700
Practice Fax:
1891030110 — JESSICA L MASTERSON LCSW
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1760800700 — DR. SAMUEL H GARTNER M.D.
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Practice Fax: 631-370-1714
1093118283 — ANDREW C YANG PHARMD
Practice Location Address:
197 HALF HOLLOW RD , PHARMACY DEPT
DIX HILLS, NY
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Practice Fax: 631-370-1671
1508330374 — MS. JESSICA MCGINN LCSW
Practice Location Address:
197 HALF HOLLOW RD
DIX HILLS, NY
11746-5859
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1104546266 — CHRISTOPHER J CARDOZA RN
Practice Location Address:
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Practice Fax:

Directions to “ OBIAMAKA CHIEGBOROM MD” Practice Location

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