Individual provider · Type 1 NPI

Ejiro Vivian Agboro-Idahosa, MD

Child & Adolescent Psychiatry Physician · Elmira, NY

NPI number 1104089390 Active

Practice location

555 Saint Josephs Blvd
Elmira, NY 14901-3223

Call (607) 737-7002 Map

Fax (607) 737-1529

Mailing address

571 Saint Josephs Blvd Fl 2
Elmira, NY 14901-3230

Specialties and licenses

TaxonomyCodeLicense
Psychiatry Physician 2084P0800X38473 (IA)
Child & Adolescent Psychiatry Physician Primary 2084P0804X38473 (IA)
Psychiatry Physician 2084P0800X275859 (NY)

Child & Adolescent Psychiatry Physician: 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.

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About NPI 1104089390

Ejiro Vivian Agboro-Idahosa, MD's National Provider Identifier is 1104089390, issued on Jul 8, 2008. The primary taxonomy on file is Child & Adolescent Psychiatry Physician (2084P0804X), and the practice location is in Elmira, NY. The record was last updated on Jun 8, 2016.