Healthcare Provider Details

I. General information

NPI: 1013537976
Provider Name (Legal Business Name): FRANK CHIDI OGBONNA MD/DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 E MAIN ST
MIDDLETOWN NY
10940-2650
US

IV. Provider business mailing address

20 E 3RD ST
MOUNT VERNON NY
10550-3989
US

V. Phone/Fax

Practice location:
  • Phone: 845-333-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number2025029458
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: