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NPI Code Detail

MEDICARE: DR. CHIDIADI JULIET ODODO MD

MEDICARE: DR. CHIDIADI JULIET ODODO 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
1208000000XPediatrics Physician208744NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2208744OTHERNYLICENSE#

General Provider Information

NPI Number : 1639146020
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHIDIADI JULIET ODODO MD
Provider Business Mailing Address
First Line : 4118 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10466-3008
Country : US
Telephone Number : 718-231-8200
Fax Number : 718-231-8205
Provider Business Practice Location Address
First Line : 4118 WHITE PLAINS RD
Second Line :
City : BRONX
State : NY
Zip : 10466-3008
Country : US
Telephone Number : 718-231-8200
Fax Number : 718-231-8205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 12/06/2021

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