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General NPI Number Information
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NPI Number | 1376502492
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Entity Type | Individual
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Provider Name | UDEME D EKONG M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/18/2006
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Last Update Date | 01/07/2013
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Provider Practice Location Address
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Address Line | 20 YORK ST YALE NEW HAVEN HOSPITAL
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-785-4649
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Fax | 203-785-3365
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Provider Business Mailing Address
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Address Line | PO BOX 208064 DEPT OF PEDIATRIC GASTROENTEROLOGY RM 4093
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City | NEW HAVEN
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State | CT
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Zip | 06520-8064
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Country | US
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Telephone | 203-785-4649
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Fax | 203-785-3365
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | 036110223
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2080T0004X
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Taxonomy Name | Pediatric Transplant Hepatology Physician
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License Number | 051529
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License Number State | CT
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