Provider Demographics
NPI:1083180673
Name:KABA, MOURAMANI (BS)
Entity Type:Individual
Prefix:MR
First Name:MOURAMANI
Middle Name:
Last Name:KABA
Suffix:
Gender:M
Credentials:BS
Other - Prefix:MR
Other - First Name:MOURAMANI
Other - Middle Name:
Other - Last Name:KABA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:41 W 184TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-7826
Mailing Address - Country:US
Mailing Address - Phone:347-304-6737
Mailing Address - Fax:
Practice Address - Street 1:163 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-1318
Practice Address - Country:US
Practice Address - Phone:718-789-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator