Basic Information
| Provider Information | |||||||||
| NPI: | 1285847863 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EBERE | ||||||||
| FirstName: | CHIAGOZIE | ||||||||
| MiddleName: | ADAOBI | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ADIBE | ||||||||
| OtherFirstName: | CHIAGOZIE | ||||||||
| OtherMiddleName: | ADAOBI | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 107 W 4TH ST | ||||||||
| Address2: | MOUNT VERNON NEIGHBORHOOD HEALTH CENTER | ||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105504002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146997200 | ||||||||
| FaxNumber: | 9146990837 | ||||||||
| Practice Location | |||||||||
| Address1: | 107 W 4TH ST | ||||||||
| Address2: | MOUNT VERNON NEIGHBORHOOD HEALTH CENTER | ||||||||
| City: | MOUNT VERNON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105504002 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146997200 | ||||||||
| FaxNumber: | 9146990837 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2007 | ||||||||
| LastUpdateDate: | 08/14/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 270659 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.