Provider Demographics
NPI:1275760068
Name:MBA-JONAS, CHIMERE NDUDI (MD)
Entity Type:Individual
Prefix:MR
First Name:CHIMERE
Middle Name:NDUDI
Last Name:MBA-JONAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 EASTCHESTER RD
Mailing Address - Street 2:APT 28F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-2140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1935 EASTCHESTER RD
Practice Address - Street 2:APT 28F
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-2140
Practice Address - Country:US
Practice Address - Phone:203-500-9244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2600662085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program