Individual
DR. KAMAU I IMAROGBE GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
11402 GUY R BREWER BLVD, SUITE 216, JAMAICA, NY 11434-1234
(718) 883-6650
(718) 883-6669
Mailing address
11402 GUY R BREWER BLVD, SUITE 216, JAMAICA, NY 11434-1234
(718) 883-6650
(718) 883-6669
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
68 016333
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00246075
—
NY
Enumeration date
11/22/2006
Last updated
06/22/2010
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