Individual provider Active NPI

Omorho Obogbaimhe

  • Pharmacist
  • Valley Stream, NY
National Provider Identifier
1174846471
Registry record updated Mar 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
051994-1 Issued in NY
Practice address
263 N Corona Ave
Valley Stream, NY 11580-4124
Phone
(516) 887-3739
NPI assigned
Mar 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 051994-1 NY Primary

Addresses

Primary practice location

263 N Corona Ave
Valley Stream, NY 11580-4124

Mailing address

263 N Corona Ave
Valley Stream, NY 11580-4124
Phone (516) 887-3739

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051994-1NYMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267401600000",
    "number": "1174846471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 N CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804124",
            "telephone_number": "516-887-3739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 N CORONA AVE",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804124",
            "telephone_number": "516-887-3739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBOGBAIMHE",
        "first_name": "OMORHO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-01",
        "last_updated": "2010-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "051994-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.