Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VICTOR OMAMODE IDAHOSA, MD
ActiveVICTOR OMAMODE IDAHOSA, MD is a Addiction Medicine (Internal Medicine) healthcare provider located in WAVERLY, New York. NPI 1528226677 is currently active in the NPPES registry. Verify at CMS.
Addiction Medicine (Internal Medicine) · WAVERLY, NY
Registration Details
- NPI Number
- 1528226677
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 27, 2008 (18.255640353682 yrs)
- Last Updated
- May 10, 2022
- License
-
276514 (NY)
Practice Information
- Address
-
348 BROAD STWAVERLY, NY, 148921441Browse NY providers · Browse ZIP 14892
- Phone
- 6078212444
- Fax
- 6079481030
- Primary Specialty
-
Addiction Medicine (Internal Medicine)
207RA0401X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.