Healthcare Provider Details

I. General information

NPI: 1427135862
Provider Name (Legal Business Name): CHUKWUEMEKA K. EFOBI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 S 3RD AVE
MT VERNON NY
10550-3313
US

IV. Provider business mailing address

30 ALBERMARLE AVE
NEW ROCHELLE NY
10801-2001
US

V. Phone/Fax

Practice location:
  • Phone: 914-699-6070
  • Fax: 914-699-8295
Mailing address:
  • Phone: 914-576-1415
  • Fax: 914-699-8295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number218236
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: