Christopher Adubor Physician PC
Organization Active NPI Nephrology Physician · Mount Vernon, NY
NPI 1043447808 · NPPES record last updated Jun 18, 2009
Key facts
- NPI
- 1043447808
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nephrology Physician 207RN0300X
- License
- 192587 (NY)
- Legal business name
- CHRISTOPHER ADUBOR PHYSICIAN PC
- Practice address
- 153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543 - Phone
- (914) 668-8080
- Fax
- (914) 668-0629
- NPI assigned
- Jun 18, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Christopher Adubor, MD
- Title
- Medical Director
- Phone
- (914) 668-8080
Subparts reporting this organization as parent 2
Corporate family (same tax ID) 3
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20101214000022 | NY | Part B Supplier - Clinic/Group Practice | 4385831593 |
Receives reassigned benefits from 1 practitioner Practice locations: Mount Vernon, NY |
National Provider Directory
- Tax ID family
- Mount Vernon Medical Practice
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | 192587 | NY | |
| Nephrology Physician |
207RN0300X | 192587 | NY | Yes |
Addresses
Primary practice location
153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Mailing address
153 Stevens Ave
Suite 4
Mount Vernon, NY 10550-2543
Phone (914) 668-8080
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01605527 | Medicaid | NY |
Other providers in Mount Vernon, NY
- Howard Choi
- Choice Limb & Brace
- Shamima Chowdhury
- Monica Christie
- Renee Christie
- Debbie Marjorie Christopher
- Kun Young Chung
- Gray J Cisco
- Willi-Nicole N Claiborne
- Lourdes Clark
All providers in Mount Vernon, NY · Nephrology Physician in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 18, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.