Basic Information
| Provider Information | |||||||||
| NPI: | 1346393477 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | OBI | ||||||||
| FirstName: | CHIBUEZE | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2569 ADAM CLAYTON POWELL JR BLVD | ||||||||
| Address2: | APT. 7K | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100393202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9176283762 | ||||||||
| FaxNumber: | 9087574494 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 E GUN HILL RD | ||||||||
| Address2: | MONTIFIORE MED. CNTR-ADVANCED IMAGING (GHMRI) | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104672159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7187985449 | ||||||||
| FaxNumber: | 7187985376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/20/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 010574 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.