Healthcare Provider Details

I. General information

NPI: 1285847863
Provider Name (Legal Business Name): CHIAGOZIE ADAOBI EBERE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHIAGOZIE ADAOBI ADIBE MD

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W 4TH ST MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
MOUNT VERNON NY
10550-4002
US

IV. Provider business mailing address

107 W 4TH ST MOUNT VERNON NEIGHBORHOOD HEALTH CENTER
MOUNT VERNON NY
10550-4002
US

V. Phone/Fax

Practice location:
  • Phone: 914-699-7200
  • Fax: 914-699-0837
Mailing address:
  • Phone: 914-699-7200
  • Fax: 914-699-0837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number270659
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: