National Provider Identifier Database

EJIRO V AGBORO IDAHOSA, MD – NPI #1104089390
Child & Adolescent Psychiatry

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.


Contact Information

EJIRO V AGBORO IDAHOSA, MD
555 SAINT JOSEPHS BLVD
ELMIRA, NY14901-3223
Phone: 607-737-7002
Fax: 607-737-1529
Website:
Specialty Taxonomy Code
* Child & Adolescent Psychiatry 2084P0804X
Psychiatry 2084P0800X

* Indicates primary specialty

NPI Profile & details for EJIRO V AGBORO IDAHOSA

NPI Number 1104089390
Credentials MD
Entity Individual
Enumeration date 07/08/2008
Last updated 06/08/2016 - About 10 years ago
Sole proprietor1 No
Identifiers
  • IA License #: 38473
  • NY License #: 275859
  • NY Medicaid: 04061661
  • IA Other: 1243767 CONTROLLED SUBSTANCE CERTIFICATE
  • IA Other: 38473 IOWA LICENSE
  • NY Other: 275859 STATE LICENSE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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