Individual
KEBA RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1176 5TH AVE, NEW YORK, NY 10029-6503
(212) 241-8709
Mailing address
5124 AVENUE K, BROOKLYN, NY 11234-3218
(347) 633-1506
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F308840-1
NY
Other
Enumeration date
03/07/2020
Last updated
03/07/2020
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