Provider Demographics
NPI:1962464594
Name:ADUBOR, CHRISTOPHER OBHOKHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:OBHOKHAN
Last Name:ADUBOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:153 STEVENS AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2543
Mailing Address - Country:US
Mailing Address - Phone:914-668-8080
Mailing Address - Fax:914-668-0629
Practice Address - Street 1:153 STEVENS AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2543
Practice Address - Country:US
Practice Address - Phone:914-668-8080
Practice Address - Fax:914-668-0629
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY192587207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01605527Medicaid
NYF91576Medicare UPIN
0C7231Medicare ID - Type UnspecifiedCEDICARE PROVIDER NUMBER