Individual provider Active NPI

Ignatius E Emeghebo, M.D.

  • Primary Care Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1629136619
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
134083 Issued in NY
Practice address
5606 Snyder Ave
Brooklyn, NY 11203-4711
Phone
(718) 342-4600
Fax
(718) 342-4601
NPI assigned
Dec 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 134083 NY Primary

Addresses

Primary practice location

5606 Snyder Ave
Brooklyn, NY 11203-4711

Mailing address

5606 Snyder Ave
Brooklyn, NY 11203-4711
Phone (718) 342-4600

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
134083NYMDPrimary Care Clinic/Center

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629136619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5606 SNYDER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112034711",
            "telephone_number": "718-342-4600",
            "fax_number": "718-342-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5606 SNYDER AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112034711",
            "telephone_number": "718-342-4600",
            "fax_number": "718-342-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMEGHEBO",
        "first_name": "IGNATIUS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NY",
            "license": "134083",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.