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General NPI Number Information
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NPI Number | 1619105483
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Entity Type | Individual
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Provider Name | CHIOMA OKAFOR-MBAH GOMEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 3251 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10461-4509
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Country | US
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Telephone | 718-792-7600
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Fax | 718-239-0182
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Provider Business Mailing Address
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Address Line | 3251 WESTCHESTER AVE
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City | BRONX
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State | NY
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Zip | 10461-4509
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Country | US
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Telephone | 718-792-7600
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Fax | 718-239-0182
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 266343
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License Number State | NY
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