Imarogbe Grantham, Kamau I

Imarogbe Grantham, Kamau I is an individual health care provider with primary practice located at 11402 Guy R Brewer Blvd Suite 216, Jamaica NY 11434-1234. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Imarogbe Grantham, Kamau I can be contacted via phone (718) 883-6650.

Contact Information

Primary practice address
11402 Guy R Brewer Blvd Suite 216 Jamaica NY 11434-1234
Phone: (718) 883-6650
Fax: (718) 883-6669
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 68 016333 New York

Profile Details

NPI number 1285709295
LBN Legal business name Imarogbe Grantham, Kamau I
Credentials PH. D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2006
Last updated Jun 22nd, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285709295 NPPES
New York MEDICAID 00246075

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