Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Dr. Ejiro Vivian Agboro-Idahosa, M.D

Child & Adolescent Psychiatry Physician in Elmira, NY · enumerated 2008.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104089390

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Registry record

Entity type Individual (Type 1)

Name Dr. Ejiro Vivian Agboro-Idahosa

Credential M.D

Sex Female

Practice address 555 Saint Josephs Blvd, Elmira, NY, 14901

Phone (607) 737-7002

Fax (607) 737-1529

Enumeration date Jul 8, 2008

Last updated in NPPES Jun 8, 2016

Taxonomy & licenses

2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians · License 38473 (IA) Secondary

2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians · License 38473 (IA) Primary

2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians · License 275859 (NY) Secondary

MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier	Type	State	Issuer
38473	Other	IA	IOWA LICENSE
275859	Other	NY	STATE LICENSE
1243767	Other	IA	CONTROLLED SUBSTANCE CERTIFICATE
04061661	Medicaid	NY	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What is the NPI number for Ejiro Agboro-Idahosa?

The National Provider Identifier (NPI) for Ejiro Agboro-Idahosa is 1104089390, a Type 1 (individual) record in the CMS NPPES registry.

Where does Ejiro Agboro-Idahosa practice?

The practice location on file with NPPES is in Elmira, NY. Providers can have multiple locations; NPPES lists the primary practice address.

Other providers at this practice address

Browse all →

Arnot Ogden Medical Center Skilled Nursing Facility · Elmira, NY NPI 1689637829 Arnot Ogden Medical Center Rehabilitation Hospital Unit · Elmira, NY NPI 1518998855 Arnot Ogden Medical Center Psychiatric Hospital Unit · Elmira, NY NPI 1326079666 Arnot Ogden Medical Center Substance Use Disorder Rehabilitation Hospital Unit · Elmira, NY NPI 1568543510 Chunying Xu Psychiatry Physician · Elmira, NY NPI 1255404745 Arnot Ogden Medical Center Internal Medicine Physician · Elmira, NY NPI 1265580286 Sarah Watson Occupational Therapist · Elmira, NY NPI 1033253976 Bhupinder Brar Psychiatry Physician · Elmira, NY NPI 1831383066

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2016-06-08.