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:
Health care specialties
| Specialty | Code | License # | 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 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285709295 | NPPES |
| New York | MEDICAID | 00246075 |
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