Eugene Kobla Dordoye, MD

Primary specialty

Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X

License

00000000 Issued in NY

Practice address

7559 263Rd St
Glen Oaks, NY 11004-1100

Phone

(718) 470-7992

Fax

(718) 962-7712

NPI assigned

Apr 17, 2024

Last updated

Apr 17, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1790539534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 SPICEMILL ALY",
            "city": "BRYANS ROAD",
            "state": "MD",
            "postal_code": "206167008",
            "telephone_number": "540-315-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7559 263RD ST",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110041100",
            "telephone_number": "718-470-7992",
            "fax_number": "718-962-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORDOYE",
        "first_name": "EUGENE",
        "middle_name": "KOBLA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "NY",
            "license": "00000000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Franchesca Diaz, MD
• Ilana Libby Dicker, D.O.
• Robert Dicker, MD
• Courtney Alissa Dietrich, LMSW
• Allison Distefano
• Dosepack Pharmacy LLC
• Dosepack Pharmacy LLC
• Anuj P Doshi, RPH
• Ashley Duah, NP
• Duane Reade (Duane Reade #14473)

• Geriatric Psychiatry Physician in Glen Oaks, NY
• Providers in Glen Oaks, NY by specialty
• Geriatric Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.