National Provider Identifier
Agezi Igboko
Agezi Igboko is listed in the NPPES registry with a primary specialty of Nurse Practitioner in Elmira, NY and a listed phone number of (607) 796-5900.
Profile Overview
- NPI
- 1790350882
- Provider Type
- Individual
- Primary Specialty
- Nurse Practitioner
- Enumeration Date
- May 21, 2021
- Last Updated
- March 30, 2023
Practice Location
- 950 County RD
- Elmira, NY 14903
Phone: (607) 796-5900
Mailing Address
- 3165 Capriole Dr Ne
- Marietta, GA 30062-0300
Specialties
- Nurse Practitioner (363L00000X)
Full Record
- NPI
- 1790350882
- Entity Type
- Individual
- Last Name
- Igboko
- First Name
- Agezi
- Mailing Street Address
- 3165 Capriole Dr Ne
- Mailing City
- Marietta
- Mailing State
- GA
- Mailing ZIP Code
- 30062-0300
- Mailing Country
- US
- Mailing Phone
- (919) 630-4147
- Practice Street Address
- 950 County RD
- Practice City
- Elmira
- Practice State
- NY
- Practice ZIP Code
- 14903
- Practice Country
- US
- Practice Phone
- (607) 796-5900
- Enumeration Date
- May 21, 2021
- Last Updated
- March 30, 2023
- Sex
- Female
- Sole Proprietor
- Yes
- Taxonomy Group 1
- 193400000X Single Specialty Group
- Certification Date
- August 11, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Nurse Practitioner (363L00000X)