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EBENEZER ODOOM MD PC
NPI 1942642038
Internal Medicine - Geriatric Medicine in Queens Village, NY

Active since July 18, 2013
21530 HILLSIDE AVE, QUEENS VILLAGE, NY 11427(718) 740-1701(718) 740-1901 Get Directions Write a Review

NPPES record last updated: July 18, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ebenezer Odoom Md Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EBENEZER ODOOM MD PC (NPI 1942642038) is a healthcare organization registered as a geriatric medicine in Queens Village, New York and active in the NPI registry since July 2013. The organization lists Ebenezer Odoom, President, as its authorized official.

NPPES Registry Identity

NPI1942642038
Entity TypeOrganization
Primary Taxonomy207RG0300X
Legal Business NameEBENEZER ODOOM MD PC
Location Address21530 HILLSIDE AVEQueens Village, NY 11427-1831
Mailing Address21530 Hillside AveQueens Village, NY 11427-1831 · (718) 740-1701 · Fax (718) 740-1901
Phone(718) 740-1701
Fax(718) 740-1901
Organization SubpartNo
Authorized OfficialEbenezer OdoomPresident · (347) 276-4570
Enumeration DateJuly 18, 2013
✔ NPI 1942642038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Geriatric MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207RG0300X
Definition
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.
Also ListedPediatricsTaxonomy 208000000X
21530 HILLSIDE AVE, Queens Village, NY 11427
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EBENEZER KOFI BENTUM ODOOM MD
Internal Medicine (Geriatric Medicine)
21530 HILLSIDE AVE
QUEENS VILLAGE, NY 11427
Queens County (718) 740-1701
MR. MARK CELESTIE ORNOPIA CAGATA RPT, DPT
Physical Therapist
21530 HILLSIDE AVE
QUEENS VILLAGE, NY 11427
Queens County (718) 776-1863

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ebenezer Odoom MD PC's NPI number?

The NPI number for Ebenezer Odoom MD PC is 1942642038. It was assigned to this organization in the NPPES registry on July 18, 2013.

Where is Ebenezer Odoom MD PC located?

Ebenezer Odoom MD PC is located at 21530 Hillside Ave, Queens Village, NY 11427. The listed phone number is (718) 740-1701.

What is Ebenezer Odoom MD PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.

When was this NPI record last updated?

The NPPES record for Ebenezer Odoom MD PC was last updated on July 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.