Healthcare Provider Details

I. General information

NPI: 1104988187
Provider Name (Legal Business Name): JAMES EFIONG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 HANSON LN
NEW ROCHELLE NY
10804-1725
US

IV. Provider business mailing address

171 HANSON LN
NEW ROCHELLE NY
10804-1725
US

V. Phone/Fax

Practice location:
  • Phone: 914-667-5907
  • Fax: 914-667-5997
Mailing address:
  • Phone: 914-667-5907
  • Fax: 914-667-5997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number166369
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: