Provider Demographics
NPI:1689624785
Name:ORIBE, EMILIO (MD)
Entity Type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:ORIBE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 E 78TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0406
Mailing Address - Country:US
Mailing Address - Phone:212-794-2281
Mailing Address - Fax:212-517-9551
Practice Address - Street 1:162 E 78TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0406
Practice Address - Country:US
Practice Address - Phone:212-794-2281
Practice Address - Fax:212-517-9551
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1681972084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE96030Medicare UPIN