Provider Demographics
NPI:1346393477
Name:OBI, CHIBUEZE C (PA)
Entity Type:Individual
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First Name:CHIBUEZE
Middle Name:C
Last Name:OBI
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2569 ADAM CLAYTON POWELL JR BLVD
Mailing Address - Street 2:APT. 7K
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3202
Mailing Address - Country:US
Mailing Address - Phone:917-628-3762
Mailing Address - Fax:908-757-4494
Practice Address - Street 1:200 E GUN HILL RD
Practice Address - Street 2:MONTIFIORE MED. CNTR-ADVANCED IMAGING (GHMRI)
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2159
Practice Address - Country:US
Practice Address - Phone:718-798-5449
Practice Address - Fax:718-798-5376
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY010574363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant