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General NPI Number Information
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NPI Number | 1376919589
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Entity Type | Individual
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Provider Name | KAMMI GRAYSON DO
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Gender | Female
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Dates
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Enumeration Date | 08/11/2015
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 724 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10016-2710
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Country | US
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Telephone | 929-455-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 724 2ND AVE
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City | NEW YORK
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State | NY
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Zip | 10016-2710
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Country | US
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Telephone | 929-455-2323
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 66848
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 66848
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 314059
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License Number State | NY
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