Organization Active NPI

Obosa Medical Services,PC

  • Interventional Pain Medicine Physician
  • Mount Vernon, NY
National Provider Identifier
1659639730
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
193487 Issued in NY
Legal business name
OBOSA MEDICAL SERVICES,PC
Practice address
140 Stevens Ave
Mount Vernon, NY 10550-2515
Phone
(914) 530-2323
Fax
(914) 530-2320
NPI assigned
Apr 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Authorized official

Name
Dr. Francis O Agbonkpolo, M.D
Title
Owner
Phone
(914) 530-2323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208VP0014X 193487 NY Primary

Addresses

Primary practice location

140 Stevens Ave
Mount Vernon, NY 10550-2515

Mailing address

11 Golden Rd
Montebello, NY 10901-3220
Phone (914) 530-2323

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1335398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1659639730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GOLDEN RD",
            "city": "MONTEBELLO",
            "state": "NY",
            "postal_code": "109013220",
            "telephone_number": "914-530-2323",
            "fax_number": "914-530-2320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 STEVENS AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105502515",
            "telephone_number": "914-530-2323",
            "fax_number": "914-530-2320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBOSA MEDICAL SERVICES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "AGBONKPOLO",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "914-530-2323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NY",
            "license": "193487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.