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General NPI Number Information
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NPI Number | 1467555458
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Entity Type | Individual
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Provider Name | FRANCIS O. AGBONKPOLO M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 140 STEVENS AVE
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City | MOUNT VERNON
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State | NY
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Zip | 10550-2515
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Country | US
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Telephone | 914-530-2323
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Fax | 914-530-2320
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Provider Business Mailing Address
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Address Line | 11 GOLDEN RD
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City | MONTEBELLO
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State | NY
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Zip | 10901-3220
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Country | US
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Telephone | 914-530-2323
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Fax | 914-530-2320
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 193784
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License Number State | NY
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