CHIDUBEM MATTHEW OBEGOLU (NPI# 1205306693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205306693 |
| Entity Type | Individual |
| Full Name | CHIDUBEM MATTHEW OBEGOLU |
| Credential | MD |
| Practice Address |
9131 175th St Jamaica NY 11432-5517 |
| Mailing Address |
10815 Seaview Ave Apt 40b Brooklyn NY 11236-4682 |
| Practice Telephone | 7186576363 |
| Mailing Telephone | 8172174412 |
| Enumeration Date | 2018-11-28 |
| Last Update Date | 2018-11-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | P14162 | NY | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6411 Beach Channel Dr, Arverne, NY 116921412 | 7189450700 |
| Street Address |
9131 175TH ST |
| City | JAMAICA |
| State | NY |
| Zip Code | 11432-5517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013963297 | Berhane Wubshet | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2006-05-26 |
| 1992322101 | Mohammed Shahidul Islam | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2020-07-03 |
| 1265063358 | A S M Tazul Islam | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2020-01-28 |
| 1366914665 | Deidre Alana Hamlet | Licensed Practical Nurse | 9131 175th St, Jamaica, NY 11432-5517 | 2018-12-26 |
| 1821569377 | Friday Okonado Akatugba | General Practice | 9131 175th St, Jamaica, NY 11432-5517 | 2018-12-10 |
| 1336544766 | Alfred Bircaj Physician PC | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2014-10-28 |
| 1891942645 | Peyman Younesi | Internal Medicine | 9131 175th St, Jamaica, NY 11432-5517 | 2008-08-23 |
| 1710050554 | Highland Care Center, Inc | Skilled Nursing Facility | 9131 175th St, Jamaica, NY 11432-5517 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396361259 | Banani Road 11 LLC | Pharmacy | 181-04 Hillside Ave, Jamaica, NY 11432 | 2020-06-17 |
| 1023633450 | Staphanie Anang | Licensed Practical Nurse | 30 Wexford Terrace Apt 3 Jj., Jamaica, NY 11432 | 2020-06-11 |
| 1205459476 | Jasmine Kaur Sandhu | Student in an Organized Health Care Education/Training Program | 87-68 164th St, N Building, 7th Floor, Rm N733, Jamaica, NY 11432 | 2020-05-22 |
| 1225650385 | Alli El-ijla | Student in an Organized Health Care Education/Training Program | Queens Hospital Center 82-68 164th Street, Jamaica, NY 11432 | 2020-05-12 |
| 1346869955 | Liane Zwetzich | Student in an Organized Health Care Education/Training Program | Queens Hospital Center, 82-68 164th Street, Jamaica, NY 11432 | 2020-04-14 |
| 1528697141 | Bahtiyar Toz | Student in an Organized Health Care Education/Training Program | 82-68 164th Street Queens Hospital Center, Jamaica, NY 11432 | 2020-04-06 |
| 1366089468 | Alisha Jnobaptiste | Counselor | 87-59 171 St., Jamaica, NY 11432 | 2019-12-08 |
| 1356995054 | Shawnette Natasha Brown | Counselor | 178-02/04 Jamaica Ave, Jamaica, NY 11432 | 2019-07-31 |
| 1518527142 | Magdalene Vidal | Case Manager/Care Coordinator | 177 30 Wexford Terrace, Suite A, Jamaica, NY 11432 | 2019-06-17 |
| 1811550338 | Rong Fan | Student in an Organized Health Care Education/Training Program | 88-68 164th St, Dept of Ob/gyn Rm B265, Jamaica, NY 11432 | 2019-04-19 |
| Find all providers in zip 11432 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861818650 | Michael Yakubov Jacobi | General Practice | 8335 139th St, Apt 1r, Jamaica, NY 11435-1600 | 2014-03-17 |
| 1992051163 | Charles Henry Ulrich | General Practice | 110-00 Rockaway Blvd., The New York Racing Association, Inc, Jamaica, NY 11417 | 2012-07-25 |
| 1043599863 | Physician Medical Services, PC | General Practice | 8216 164th Pl, 1st Floor, Jamaica, NY 11432-1238 | 2011-08-10 |
| 1437305174 | Priority Medical Group, P.C. | General Practice | 16402 Jamaica Ave, Jamaica, NY 11432-4914 | 2008-08-13 |
| 1659559052 | Ernst Jean | General Practice | 87-59 171st St, Jamaica, NY 11432-4554 | 2008-02-07 |
| 1457473035 | Ralph Robert Squitieri | General Practice | St Johns University Vincentian Residence, 8000 Utopia Parkway, Jamaica, NY 11439-0001 | 2007-04-04 |
| 1821569377 | Friday Okonado Akatugba | General Practice | 9131 175th St, Jamaica, NY 11432-5517 | 2018-12-10 |
| 1902281850 | Jamaica Medical Center Ny PC | General Practice | 9016 Sutphin Blvd, Jamaica, NY 11435-3636 | 2015-07-21 |
| 1841567492 | Leonardo Ramos Rivera Jr. | General Practice | 18730 Hillside Ave, Jamaica, NY 11432-3216 | 2011-11-28 |
| 1841430949 | Sonja Marie Geourzoung | General Practice | 90-37 Parsons Blvd, Jamaica, NY 11432 | 2009-03-02 |
| Find all providers in JAMAICA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.