Diane Sophia Ojugbeli, MD
Individual provider Active NPI Family Medicine Physician · Chittenango, NY
NPI 1619088812 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1619088812
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 219809-1 (NY)
- Practice address
- 304 Genesee St
Chittenango, NY 13037-0001 - Phone
- (315) 687-6467
- Fax
- (315) 687-6041
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219809-1 | NY | MD | Family Medicine Physician |
Interoperability endpoints
- dojugbeli@hiemail.healtheconnections.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 219809-1 | NY | Yes |
Addresses
Primary practice location
304 Genesee St
Chittenango, NY 13037-0001
Mailing address
1004 Gill St
Chittenango, NY 13037-0001
Phone (315) 687-7319
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02105113 | Medicaid | NY |
Other providers in Chittenango, NY
- Randee Ann McCormick
- Medi-Go Medical Transportation Services, LLC
- Cynthia Secord Milnamow
- Nap Pharmacy LLC
- Rasel Negron Ocasio
- Ifechukwude Onyeoba Ojugbeli
- Ave Maria Pasho
- Diane Paul
- Cheryl A Pavlov-Shapiro
- Cynthia F Phillips
All providers in Chittenango, NY · Family Medicine 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 Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.