Provider Demographics
NPI:1477518231
Name:OFONAGORO, CHINYERE EBERE (MD)
Entity Type:Individual
Prefix:DR
First Name:CHINYERE
Middle Name:EBERE
Last Name:OFONAGORO
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:243 NORTH RD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1172
Mailing Address - Country:US
Mailing Address - Phone:845-451-7251
Mailing Address - Fax:845-451-7757
Practice Address - Street 1:537 BLOOMING GROVE TPKE
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-7843
Practice Address - Country:US
Practice Address - Phone:845-561-8500
Practice Address - Fax:845-561-8855
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY207719207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01922123Medicaid
NY01922123Medicaid
NYG88195Medicare UPIN