Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ebenezer Odoom MD PC

Organization Geriatric Medicine (Internal Medicine) Physician · NPI 1942642038

Ebenezer Odoom MD PC is a Geriatric Medicine (Internal Medicine) Physician in Queens Village, New York. Registered with an NPI since 2013.

In the registry since
2013
Specialties on file
2
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

21530 Hillside Ave
Queens Village, NY 11427-1831
Phone: (718) 740-1701
Fax: (718) 740-1901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X
Pediatrics Physician Taxonomy 208000000X

Record details

NPI number1942642038
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ebenezer Odoom — President · (347) 276-4570
NPI enumeratedJuly 18, 2013
Last updated in NPPESJuly 18, 2013
Mailing address21530 Hillside Ave, Queens Village, NY 11427-1831

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