Individual
KEISHA GRANDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
560 W 168TH ST, NEW YORK, NY 10032-3917
(347) 424-9242
Mailing address
845 PINE ST APT 2, BROOKLYN, NY 11208-5527
(347) 424-9242
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
676804
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
676804
NY
Other
Enumeration date
02/22/2019
Last updated
01/10/2022
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